School of Medicine, University of Auckland, Auckland, New Zealand.
Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand.
Dig Liver Dis. 2019 Apr;51(4):551-558. doi: 10.1016/j.dld.2018.11.001. Epub 2018 Nov 16.
BACKGROUND & AIMS: Both liver disease (LD) and pancreatitis pose substantial burdens. There have been no general population-based studies on frequency of LD after an episode of pancreatitis. The aim of this study was to investigate the occurrence of LD in a population-based cohort of patients following pancreatitis.
Nationwide data on the general population of nearly 3 million people were used to identify retrospectively diagnoses of acute pancreatitis, chronic pancreatitis (CP), LD and cirrhosis from 1998 to 2016. Acute pancreatitis was categorised as first (FAP) or recurrent (RAP) episode. Number of pancreatitis recurrences prior to LD diagnosis was determined.
A total of 20,931 pancreatitis patients were included, of which 874 developed LD following pancreatitis. The incidence of LD in FAP was 115.59 (95% confidence interval 102.19-128.98), in RAP - 217.63 (95% confidence interval 173.31-261.94), and in CP - 539.43 (95% confidence interval 494.72-584.13) patients per 100,000 pancreatitis patients per year. There was a significant increase in the probability of LD with increasing number of pancreatitis recurrences and, for the same number of pancreatitis recurrences, LD was significantly more frequent after CP than RAP (hazard ratio 1.666 (95% confidence interval 1.322-2.098; p = <0.001)).
The frequency of LD increases from FAP to RAP to CP. While number of pancreatitis recurrences is a significant risk factor for development of LD, there is a higher probability of LD following CP than RAP even for the same number of recurrences. Interventions preventing pancreatitis and its progression may lower the burden of LD.
肝脏疾病（LD）和胰腺炎都带来了巨大的负担。目前还没有基于一般人群的研究调查胰腺炎后 LD 的发病频率。本研究旨在调查基于人群的胰腺炎患者队列中 LD 的发生情况。
利用近 300 万人群的全国性数据，回顾性地从 1998 年至 2016 年诊断出急性胰腺炎、慢性胰腺炎（CP）、LD 和肝硬化。将急性胰腺炎分为首发（FAP）或复发性（RAP）发作。确定 LD 诊断前胰腺炎复发的次数。
共纳入 20931 例胰腺炎患者，其中 874 例在胰腺炎后发生 LD。FAP 的 LD 发生率为 115.59（95%置信区间 102.19-128.98），RAP 为 217.63（95%置信区间 173.31-261.94），CP 为 539.43（95%置信区间 494.72-584.13）例/10 万人/年。随着胰腺炎复发次数的增加，发生 LD 的可能性显著增加，而且对于相同次数的胰腺炎复发，CP 后发生 LD 的可能性明显高于 RAP（风险比 1.666（95%置信区间 1.322-2.098；p<0.001））。
LD 的发病频率从 FAP 增加到 RAP 再增加到 CP。虽然胰腺炎复发次数是发生 LD 的重要危险因素，但即使复发次数相同，CP 后发生 LD 的可能性也高于 RAP。预防胰腺炎及其进展的干预措施可能会降低 LD 的负担。
