既往有急性胰腺炎病史患者进展为慢性胰腺炎的危险因素：基于机制定义的回顾性分析
The Risk Factors for Progression to Chronic Pancreatitis in Patients with Past-History of Acute Pancreatitis: A Retrospective Analysis Based on Mechanistic Definition.
作者信息
Yamamiya Akira, Tominaga Keiichi, Hoshi Koki, Nagashima Kazunori, Minaguchi Takahito, Haruyama Yasuo, Irisawa Atsushi
机构信息
Department of Gastroenterology, School of Medicine, Dokkyo Medical University, 880 Kitakobayashi Mibu, Tochigi 321-0293, Japan.
Integrated Research Faculty for Advanced Medical Science, School of Medicine, Dokkyo Medical University, 880 Kitakobayashi Mibu, Tochigi 321-0293, Japan.
出版信息
J Clin Med. 2022 Apr 15;11(8):2209. doi: 10.3390/jcm11082209.
BACKGROUND
According to the mechanistic definition, the history of acute pancreatitis (AP) is a risk factor for chronic pancreatitis (CP). However, the etiology and severity of previous AP involved in the progression to CP have not been clarified. Here, we investigated risk factors for the progression to CP in patients with past-history of AP.
METHODS
Sixty-four patients with AP who were followed-up for at least two years at our institution between April 2009 and March 2017 were enrolled. The multivariate analysis was performed based on the risk factors extracted by univariate analysis.
RESULTS
Among the 64 patients, 13 patients (20.3%) progressed to CP (PCP group), while 48 did not (non-PCP group). Regarding the etiology of AP, rate of alcohol AP was significantly higher in the PCP group (76.9% vs. 33.3%, = 0.003). In univariate analysis, smoking, number of previous AP, and alcohol consumption and drinking habits (Alcohol Use Disorders Identification Test-Concise; AUDIT-C) were identified as factors associated with progression to CP. Furthermore, multivariate analysis showed that AUDIT-C ≥ 6 points (male) and 4 points (female) after AP was a significant risk factor for CP ( = 0.003).
CONCLUSIONS
Our results indicated that AUDIT-C ≥ 6 points (male) and 4 points (female) after AP was a risk factor in the process of progression to CP in patients with past-history of AP.
背景
根据机制定义，急性胰腺炎（AP）病史是慢性胰腺炎（CP）的一个危险因素。然而，既往AP进展为CP所涉及的病因和严重程度尚未明确。在此，我们调查了有AP病史患者进展为CP的危险因素。
方法
纳入2009年4月至2017年3月在我院接受至少两年随访的64例AP患者。基于单因素分析提取的危险因素进行多因素分析。
结果
64例患者中，13例（20.3%）进展为CP（PCP组），48例未进展（非PCP组）。关于AP的病因，PCP组酒精性AP的发生率显著更高（76.9%对33.3%，P = 0.003）。在单因素分析中，吸烟、既往AP发作次数、饮酒量及饮酒习惯（酒精使用障碍识别测试简表；AUDIT-C）被确定为与进展为CP相关的因素。此外，多因素分析显示，AP后AUDIT-C≥6分（男性）和≥4分（女性）是CP的显著危险因素（P = 0.003）。
结论
我们的结果表明，AP后AUDIT-C≥6分（男性）和≥4分（女性）是有AP病史患者进展为CP过程中的一个危险因素。
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