Lin C C, Wang H P, Chen M F, Soon M S, Mo L R, Lin X Z, Lin S H, Yang T H, Wang T H, Lin J T
Department of Internal Medicine, National Taiwan University Hospital.
Hepatogastroenterology. 1997 May-Jun;44(15):842-8.
BACKGROUND/AIMS: This study investigates the clinical features of chronic calcifying pancreatitis (CCP) in Taiwan and also the comparative differences in the disorder as it affects orientals and occidentals.
Medical records at seven tertiary hospitals relating to patients diagnosed with CCP between 1976 and 1996 are reviewed and analyzed. Ninety patients were enrolled. Defining the calcification of the pancreas is achieved by plain film, ultrasonography, computed tomography, or histology.
CCP afflicts men more frequently than it does women, by a ratio of 3.5:1 (70 men and 20 women). The mean age is 45 years (male: 46 female: 41.4). For fifty-two patients (57.8%), alcohol is the major cause of the condition, while in others, the causes are non-alcoholic (idiopathic: 31; biliary: 4; hereditary: 3). Alcoholism is mainly associated with males and younger sufferers. The major complications are diabetes mellitus (53.3%), cysts or pseudocysts (21.1%), and biliary stricture or stones (20%). Pancreatic adenocarcinoma and splenic vein thrombosis were found in six and five patients, respectively. Three patients died from cancers of other than pancreatic origin (lung: 1;liver: 1;bile duct: 1). Thirty-three patients were treated surgically of which thirteen (39.4%), including one with pancreatic auto transplantation, improved. Fifty-seven patients received medical treatment but only eleven (19.3%) improved.
The clinical features of CCP in Taiwan are notably similar to those manifesting in western countries and in Japan. With the changes in life style and increased alcoholic consumption in Taiwan, the prevalence of CCP may increase and its demographic features may alter in the future.
背景/目的:本研究调查台湾地区慢性钙化性胰腺炎(CCP)的临床特征,以及该疾病在东方人和西方人之间的比较差异。
回顾并分析了1976年至1996年间7家三级医院中诊断为CCP患者的病历。共纳入90例患者。通过X线平片、超声、计算机断层扫描或组织学检查确定胰腺钙化。
CCP在男性中的发病率高于女性,比例为3.5:1(70例男性和20例女性)。平均年龄为45岁(男性:46岁;女性:41.4岁)。52例患者(57.8%)的主要病因是酒精,其他患者的病因是非酒精性的(特发性:31例;胆源性:4例;遗传性:3例)。酒精中毒主要与男性和年轻患者相关。主要并发症为糖尿病(53.3%)、囊肿或假性囊肿(21.1%)以及胆管狭窄或结石(20%)。分别在6例和5例患者中发现胰腺腺癌和脾静脉血栓形成。3例患者死于非胰腺来源的癌症(肺癌:1例;肝癌:1例;胆管癌:1例)。33例患者接受了手术治疗,其中13例(39.4%)病情改善,包括1例接受胰腺自体移植的患者。57例患者接受了药物治疗,但只有11例(19.3%)病情改善。
台湾地区CCP的临床特征与西方国家和日本的显著相似。随着台湾地区生活方式的改变和酒精消费量的增加,CCP的患病率可能会上升,其人口统计学特征未来可能会发生变化。