Bozkurt T, Maroske D, Adler G
Department of Internal Medicine & Gastroenterology, Philipps-University of Marburg, Germany.
Hepatogastroenterology. 1995 Feb;42(1):55-8.
The aim of the present study was to investigate the exocrine pancreatic function after recovery from necrotizing pancreatitis. The exocrine function was analysed in 53 patients who had recovered from their first attack of necrotizing pancreatitis. In a group of 23 patients (Group A), three follow-up studies were performed between four weeks and 12 months after recovery from acute pancreatitis. A second group of 30 patients (Group B) was submitted to only one function test 18 months after recovery from acute necrotizing pancreatitis. Exocrine pancreatic function was observed after endogenous stimulation using the Lundh test meal. In Group A, after four weeks 74% of the patients had mild-to-moderate insufficiency, while 26% suffered from severe impairment of pancreatic function. Twelve months after recovery, only 16% of the patients showed a normal pancreatic response, while 84% still had pancreatic insufficiency of variable severity. In Group B, 13% of the patients showed a normal pancreatic response, while mild-to-moderate insufficiency was observed in 81%. Severe pancreatic insufficiency was measured only in 6% of these patients. After recovery from necrotizing pancreatitis persistent global or dissociated functional insufficiency is found in 80-85% of the cases. Individual pancreatic enzyme secretion varies quiet considerably during the course of recovery in the follow-up period.
本研究的目的是调查坏死性胰腺炎恢复后的胰腺外分泌功能。对53例首次坏死性胰腺炎发作后已康复的患者的外分泌功能进行了分析。在一组23例患者(A组)中,在急性胰腺炎恢复后的4周和12个月之间进行了3次随访研究。第二组30例患者(B组)在急性坏死性胰腺炎恢复18个月后仅接受了一次功能测试。使用伦德试验餐在内源性刺激后观察胰腺外分泌功能。在A组中,4周后74%的患者有轻度至中度功能不全,而26%的患者胰腺功能严重受损。恢复12个月后,只有16%的患者胰腺反应正常,而84%的患者仍有不同程度的胰腺功能不全。在B组中,13%的患者胰腺反应正常,而81%的患者观察到轻度至中度功能不全。这些患者中只有6%测量到严重胰腺功能不全。坏死性胰腺炎恢复后,80 - 85%的病例存在持续性整体或分离性功能不全。在随访期间的恢复过程中,个体胰腺酶分泌变化相当大。