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印度急性胰腺炎患者的复发率及随访中慢性胰腺炎的识别:病情进展的可能危险因素

Rate of recurrence in Indian patients presenting with acute pancreatitis and identification of chronicity on follow up: Possible risk factors for progression.

作者信息

Kalaria Rishikesh, Abraham Philip, Desai Devendra C, Joshi Anand, Gupta Tarun

机构信息

Division of Gastroenterology, P D Hinduja Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, 400 016, India.

出版信息

Indian J Gastroenterol. 2018 Mar;37(2):92-97. doi: 10.1007/s12664-018-0818-0. Epub 2018 Mar 7.

Abstract

BACKGROUND

To study the profile and long-term outcome of Indian patients presenting with acute pancreatitis and the possible risk factors for progression.

METHODS

Consecutive patients with acute or recurrent acute pancreatitis seen in our department during July 2013 to December 2014 were included. Details of past episodes were collected and patients were followed up till March 2015.

RESULTS

In the 97 patients included (mean age 47.2 [SD 16.9] years; 74 men), gallstones (37 [38.1%]) and alcohol (19 [19.6%]) were the major identified etiologies; the idiopathic (31 [32%]) group constituted a third of patients. Recurrences were more common with idiopathic etiology (14 patients out of 30 had recurrences [46.7%]) as compared to alcoholic (5 out of 19 [26.3%]) and biliary (4 out of 37 [10.8%]) pancreatitis and with mild index episode. Following the episode of acute pancreatitis, identification of chronic pancreatitis was more common with alcoholic (6 out of 18 [33%]) and idiopathic (9 out of 30 [30%]) etiology as compared to other etiologies. Longer duration of follow up, but not number of recurrent episodes, was associated with identification of chronicity in patients presenting as acute pancreatitis.

CONCLUSIONS

Out of 97 patients with acute pancreatitis, 27 (27.8%) developed recurrences with risk factors being idiopathic etiology and mild index episode. Eighteen of 97 (18.6%) patients had evidence of chronic pancreatitis on follow up, risk factors being the alcoholic and idiopathic varieties, and longer duration of follow up.

摘要

背景

研究印度急性胰腺炎患者的特征、长期预后以及病情进展的可能危险因素。

方法

纳入2013年7月至2014年12月期间在我科就诊的急性或复发性急性胰腺炎连续病例。收集既往发作的详细情况,并对患者进行随访直至2015年3月。

结果

纳入的97例患者(平均年龄47.2[标准差16.9]岁;74例男性)中,胆结石(37例[38.1%])和酒精(19例[19.6%])是主要确定的病因;特发性(31例[32%])组占患者的三分之一。与酒精性(19例中的5例[26.3%])和胆源性(37例中的4例[10.8%])胰腺炎相比,特发性病因的复发更常见(30例中有14例复发[46.7%]),且首发发作症状较轻。急性胰腺炎发作后,与其他病因相比,酒精性(18例中的6例[33%])和特发性(30例中的9例[30%])病因的患者更常被诊断为慢性胰腺炎。随访时间较长与急性胰腺炎患者慢性化的诊断相关,而不是复发次数。

结论

97例急性胰腺炎患者中,27例(27.8%)复发,危险因素为特发性病因和首发发作症状较轻。97例患者中有18例(18.6%)在随访时有慢性胰腺炎的证据,危险因素为酒精性和特发性类型以及随访时间较长。

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