Braganza J M, Hunt L P, Warwick F
Gastroenterology. 1982 Jun;82(6):1341-7.
Forty-five patients with chronic pancreatitis (of whom only 14 had pancreatic calculi) were investigated by endoscopic pancreatography and the secretin-pancreozymin test in order to explore the relationship between exocrine function and duct morphology in this disease. Each pancreatogram was assigned a score that ranged from 1 when the duct system was normal to 6 when a chain-of-lakes replaced the main duct; the scores attained were compared with the respective secretory volumes, bicarbonate concentrations, bicarbonate outputs, and trypsin outputs of exocrine secretions. Although a significant negative correlation emerged in each instance, the secretory overlap between the six subgroups was so marked as to render impractical any prospect of accurately predicting the pancreatogram appearance on the basis of prevailing pancreatic function in any individual case, or vice versa. The likely explanation for this result is that (a) chronic pancreatitis is a patchy process in which the acini and ducts are variably affected, and (b) destruction of parenchyma and obstruction to drainage of secretions contribute in varying proportions to the decrease in exocrine function.
为了探究慢性胰腺炎患者外分泌功能与导管形态之间的关系，对45例慢性胰腺炎患者（其中仅14例有胰腺结石）进行了内镜胰管造影和促胰液素-胰酶泌素试验。每张胰管造影片都被赋予一个分数，范围从导管系统正常时的1分至出现串珠状改变替代主胰管时的6分；将获得的分数与外分泌液各自的分泌量、碳酸氢盐浓度、碳酸氢盐输出量以及胰蛋白酶输出量进行比较。尽管在每种情况下都出现了显著的负相关，但六个亚组之间的分泌重叠非常明显，以至于根据任何个体病例中现有的胰腺功能准确预测胰管造影表现，或者反之，都是不切实际的。这一结果的可能解释是：（a）慢性胰腺炎是一个局灶性过程，其中腺泡和导管受到不同程度的影响；（b）实质破坏和分泌物引流受阻对外分泌功能下降的贡献比例各不相同。
