Segal I
Gastrointestinal Unit, Chris Hani Baragwanath Hospital, Johannesburg, South Africa. segal.netactive.co.za
Digestion. 1998;59 Suppl 4:25-35. doi: 10.1159/000051440.
Both acute pancreatitis and chronic pancreatitis now appear to be endemic at Soweto, South Africa, and they carry a substantial toll in terms of morbidity and mortality. Case-control studies identified the same three environmental factors in each disease, namely, heavy alcohol consumption, marked exposure to occupational chemicals and low intake of fruit (a major source of vitamin C). This congruity, and parallel trends on blood biochemical analysis indicating heightened free radical activity coupled with poor antioxidant status, suggest that the two diseases may be part of a pathobiological spectrum that is linked by pancreatic oxidant stress. Further, asymptomatic chronic alcoholics had plasma glutathione concentrations that were midway between the values in non-alcoholic controls and patients with chronic pancreatitis, being significantly different from each. And, finally, apparently healthy Sowetans were actually in a state of oxidant stress that was tied in with their very poor vitamin C status, and lower serum selenium concentrations than in the UK. These data, and evidence that both antioxidants mitigate against alcoholic toxicity in experimental studies, may offer scope for disease prophylaxis in this unprivileged community.
急性胰腺炎和慢性胰腺炎目前在南非索韦托似乎都很常见，它们在发病率和死亡率方面造成了巨大损失。病例对照研究在每种疾病中都确定了相同的三个环境因素，即大量饮酒、大量接触职业化学品和水果（维生素C的主要来源）摄入量低。这种一致性，以及血液生化分析显示自由基活性增强且抗氧化状态不佳的平行趋势，表明这两种疾病可能是由胰腺氧化应激联系起来的病理生物学谱系的一部分。此外，无症状的慢性酗酒者血浆谷胱甘肽浓度介于非酒精对照组和慢性胰腺炎患者的值之间，彼此差异显著。最后，表面健康的索韦托人实际上处于氧化应激状态，这与他们非常低的维生素C水平以及比英国更低的血清硒浓度有关。这些数据，以及抗氧化剂在实验研究中都能减轻酒精毒性的证据，可能为这个贫困社区的疾病预防提供空间。
