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糖尿病患者的胰腺囊性病变

Pancreatic cystic lesions in diabetes mellitus patients.

作者信息

Rozek Martyna, Lipinski Michal, Jozefik Ewa, Znajdek Zuzanna, Kiziak Marta, Sznurkowska Marta, Tatur Jacek, Degowska Malgorzata, Rydzewska Grazyna

机构信息

Department of Gastroenterology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland.

Collegium Medicum, Jan Kochanowski University, Kielce, Poland.

出版信息

Prz Gastroenterol. 2021;16(1):62-66. doi: 10.5114/pg.2020.96080. Epub 2020 Jun 4.

Abstract

INTRODUCTION

According to the literature exocrine pancreatic insufficiency is relatively common among patients with diabetes mellitus (DM). Pseudocysts are the most common cystic lesions and may be formed in the setting of acute or chronic pancreatitis. However, whether DM is involved or not in pancreatic cyst formation is still not well established.

AIM

To investigate the frequency and risk factors of cystic lesions in diabetic patients.

MATERIAL AND METHODS

One hundred and sixty-one patients with DM, with no previous history of pancreatic diseases, were prospectively included in the study. Endosonography followed by fine needle aspiration biopsy was then performed.

RESULTS

Finally, 33 of 161 patients (20.5%) were recognized with cystic lesions of the pancreas. Among them 5 patients were classified as cystic neoplasms, and 28 as pseudocysts. In the group of patients with pseudocysts, cystic lesions were significantly more prevalent in individuals with DM lasting less than 3 years. Prevalence of cystic lesions was significantly higher in metformin users in comparison to other diabetic patients ( < 0.05). Cystic lesions were more frequent in patients above 50 years of age ( < 0.05).

CONCLUSIONS

The prevalence of cystic lesions in the diabetic population is higher than in the general population. DM seems to play a major role in the process of cyst development, especially in patients without previous history of pancreatitis. Higher prevalence of cystic lesions in early diabetes seems to be the first stage of pancreatic injury. The exact role of diabetes duration and type of treatment should be established.

摘要

引言

根据文献,外分泌性胰腺功能不全在糖尿病患者中相对常见。假性囊肿是最常见的囊性病变,可在急性或慢性胰腺炎的情况下形成。然而,糖尿病是否参与胰腺囊肿的形成仍未明确。

目的

研究糖尿病患者囊性病变的发生率及危险因素。

材料与方法

前瞻性纳入161例无胰腺疾病既往史的糖尿病患者。随后进行内镜超声检查及细针穿刺活检。

结果

最终,161例患者中有33例(20.5%)被诊断为胰腺囊性病变。其中5例为囊性肿瘤,28例为假性囊肿。在假性囊肿患者组中,病程小于3年的糖尿病患者囊性病变更为普遍。与其他糖尿病患者相比,使用二甲双胍的患者囊性病变发生率显著更高(P<0.05)。50岁以上患者囊性病变更为常见(P<0.05)。

结论

糖尿病患者中囊性病变的发生率高于普通人群。糖尿病似乎在囊肿形成过程中起主要作用,尤其是在无胰腺炎既往史的患者中。糖尿病早期囊性病变发生率较高似乎是胰腺损伤的第一阶段。应明确糖尿病病程及治疗类型的确切作用。

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