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酒精性、非酒精性和自身免疫性胰腺炎中炎症性肠病的患病率。

Prevalence of inflammatory bowel disease in alcoholic, non-alcoholic and autoimmune pancreatitis.

作者信息

Schneider Alexander, Hirth Michael, Weiss Christel, Weidner Philip, Antoni Christoph, Thomann Anne, Reindl Wolfgang, Ebert Matthias P, Pfützer Roland H

机构信息

Department of Medicine II, University Medical Center Mannheim, Medical Faculty of the University of Heidelberg, Mannheim, Germany.

Department of Medical Statistics, University Medical Center Mannheim, Medical Faculty of the University of Heidelberg, Mannheim, Germany.

出版信息

Z Gastroenterol. 2018 May;56(5):469-478. doi: 10.1055/s-0043-123881. Epub 2018 May 7.

Abstract

OBJECTIVES

Patients with inflammatory bowel disease (IBD) frequently reveal features of pancreatic inflammation. However, the prevalence of IBD in patients with alcoholic pancreatitis (AP) and nonalcoholic pancreatitis (NAP) has not yet been determined, and the prevalence of IBD in patients with autoimmune pancreatitis (AiP) from Germany is unknown.

AIMS

Thus, we aimed, first, to determine the prevalence of IBD in AP, NAP, and AiP from a tertiary center in Germany and, second, to characterize patients with AiP and IBD.

METHODS

We performed a retrospective cross-sectional study to determine the prevalence of IBD in patients with different forms of pancreatitis presenting to our clinic.

RESULTS

Compared to the general population and to a control group with viral hepatitis from our clinic, we observed the most significant increase of IBD in patients with AiP (n = 3/28; p < 0.0001 vs. general population, binomial proportion test; p = 0.0112 vs. hepatitis group, Fisher's exact test), followed by a significant increase in subjects with NAP (n = 11/278; p < 0.0001 vs. general population, binomial proportion test; p = 0.0338 vs. hepatitis group, Fisher's exact test). A review of previous studies on the prevalence of IBD among patients with AiP revealed a combined prevalence of 12 % (n = 43/355). Type 2 AiP is significantly more often associated with IBD than type 1 AiP (n = 28/48, 58 % vs. n = 7/129, 5 %; combined patient cohort, p < 10E - 12; Fisher's exact test).

CONCLUSIONS

Immune-mediated mechanisms related to IBD may participate in the development of AiP, especially AiP type 2, and may also increase the risk for the development of other forms of pancreatic inflammation.

摘要

目的

炎症性肠病(IBD)患者常表现出胰腺炎症特征。然而,酒精性胰腺炎(AP)和非酒精性胰腺炎(NAP)患者中IBD的患病率尚未确定,德国自身免疫性胰腺炎(AiP)患者中IBD的患病率也未知。

目的

因此,我们的目标,一是确定德国一家三级中心的AP、NAP和AiP患者中IBD的患病率,二是对AiP和IBD患者进行特征描述。

方法

我们进行了一项回顾性横断面研究,以确定到我们诊所就诊的不同类型胰腺炎患者中IBD的患病率。

结果

与普通人群以及我们诊所的病毒性肝炎对照组相比,我们观察到AiP患者中IBD的增加最为显著(n = 3/28;与普通人群相比,二项式比例检验p < 0.0001;与肝炎组相比,Fisher精确检验p = 0.0112),其次是NAP患者显著增加(n = 11/278;与普通人群相比,二项式比例检验p < 0.0001;与肝炎组相比,Fisher精确检验p = 0.0338)。对先前关于AiP患者中IBD患病率的研究进行回顾发现,合并患病率为12%(n = 43/355)。2型AiP比1型AiP更常与IBD相关(n = 28/48,58% 对 n = 7/129,5%;合并患者队列中,p < 10E - 12;Fisher精确检验)。

结论

与IBD相关的免疫介导机制可能参与了AiP的发生发展,尤其是2型AiP,也可能增加其他形式胰腺炎症的发生风险。

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