Naruse S, Kitagawa M, Ishiguro H, Nakae Y, Kondo T, Hayakawa T
Department of Internal Medicine II, Nagoya University School of Medicine, Japan.
Pancreas. 1998 Apr;16(3):323-8.
Based primarily on our experience, we review current problems on etiology, pathogenesis, classification, diagnosis, and treatment of chronic pancreatitis. Much of the confusion and difficulty associated with chronic pancreatitis originates from the relative inaccessibility of this organ. A lack of specific and sensitive markers that are suitable for the follow-up of a long natural course of chronic pancreatitis also hinders our understanding of this disease. The resolution of the present imaging tests, even by the latest technology, is not good enough to detect early changes of the pancreas. In the past 10 years, several subgroups of patients with alcoholic and idiopathic pancreatitis have been identified based on the long-term follow-up study. Pain disappeared spontaneously in many patients during the course of the disease, but its mechanism is still poorly understood. Removal of pancreatic stones and protein plugs by chemical, endoscopic, or extracorporeal shock-wave therapy has been tried with some success, but their clinical values remain to be established. Attempts have been made to understand the etiology and pathogenesis of chronic pancreatitis at molecular levels. This approach, together with a prospective follow-up of patients, will improve our understanding on chronic pancreatitis.
主要基于我们的经验，我们回顾了慢性胰腺炎在病因、发病机制、分类、诊断和治疗方面的当前问题。与慢性胰腺炎相关的许多困惑和困难源于该器官相对难以触及。缺乏适用于慢性胰腺炎漫长自然病程随访的特异性和敏感性标志物也阻碍了我们对这种疾病的理解。即使采用最新技术，目前成像检查的分辨率也不足以检测胰腺的早期变化。在过去10年中，基于长期随访研究，已确定了酒精性和特发性胰腺炎患者的几个亚组。在疾病过程中，许多患者的疼痛会自发消失，但其机制仍知之甚少。通过化学、内镜或体外冲击波疗法清除胰腺结石和蛋白栓已取得一定成功，但其临床价值仍有待确定。人们已尝试在分子水平上理解慢性胰腺炎的病因和发病机制。这种方法，连同对患者的前瞻性随访，将提高我们对慢性胰腺炎的认识。
