首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 3期肝胆胰疾病的内镜诊疗 => 胰腺疾病 =>1 型自身免疫性胰腺炎13例..
1 型自身免疫性胰腺炎13例临床分析
Clinical features of type 1 autoimmune pancreatitis: an analysis of 13 cases
文章发布日期:2018年02月07日  来源:  作者:莫 雪,高润平,牛俊奇  点击次数:1213次  下载次数:88次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的总结1型自身免疫性胰腺炎(AIP)的临床特征, 进一步认识该病,减少误诊率,加深人们对该病的认识。方法回顾性分析2012年1月-2016年12月吉林大学第一医院收治的13例1型AIP患者的临床资料,包括一般情况、临床表现、实验室血清学检查、影像学、组织病理学、治疗及预后等。结果13例患者中男9例,女4例,平均(60.08±9.47)岁。主要临床表现为黄疸(69.2%)、腹痛(61.5%)、体质量减轻(61.5%);最常见合并累及器官为胆管受累(46.2%)、硬化性胆管炎(30.8%);23.1%患者合并糖尿病;血清学指标中92.30%患者IgG4升高2倍以上,7.69%升高1~2倍,53.85%患者CA19-9升高,69.23%患者TBil升高,三分之二以上患者转氨酶或GGT升高;影像学表现上53.8%患者CT示胰腺弥漫性肿大,46.2%为局灶性肿大,46.2%胰腺病变区低密度包囊样边缘影;病理检查显示胰腺导管周围纤维结缔组织增生,伴大量淋巴细胞、浆细胞浸润。所有患者均接受正规的糖皮质激素治疗(起始剂量泼尼松30~40 mg/d),激素治疗缓解率100%。随访时间12个月,1例患者病程中多次复发。结论1 型 AIP 是IgG4相关性疾病在胰腺的局部表现,好发于中老年男性,常伴有胰腺外病变, 激素治疗有效,预后良好,在不规范或不能长期激素治疗的情况下常有复发。
【Abstract】:ObjectiveTo investigate the clinical features of type 1 autoimmune pancreatitis (AIP), and to deepen the understanding of this disease, reduce false positive rate, and enhance people′s awareness of this disease. MethodsA retrospective analysis was performed for the clinical data of 13 patients with type 1 AIP who were admitted to The First Hospital of Jilin University from January 2012 to December 2016, including general status, clinical manifestations, laboratory serological examination, imaging findings, histopathological findings, treatment, and prognosis. ResultsOf all 13 patients, there were 9 male and 4 female patients with a mean age of 60.08±9.47 years. Major clinical manifestations included jaundice (69.2%), abdominal pain (61.5%), and weight loss (61.5%). The most common organ involved was bile duct (462%), and 30.8% of the patients had sclerosing cholangitis. Of all patients, 23.1% had diabetes. As for serological markers, 92.30% patients had more than 2 times increase in IgG4, and 7.69% had 1-2 times increase in IgG4; 53.85% patients had an increase in CA19-9; 69.23% patients had an increase in total bilirubin; more than two thirds of the patients had an increase in aminotransferases or gamma-glutamyl transpeptidase. As for imaging findings, 53.8% patients had diffuse enlargement of the pancreas on CT, 46.2% had focal enlargement of the pancreas, and 46.2% patients had low-density cyst-like shadow in pancreatic lesions. Pathological examination showed fibrous connective tissue proliferation with infiltration of lymphocytes and plasma cells. All patients were given standard glucocorticoid therapy (initial dose of prednisone: 30-40 mg/d) and the remission rate of glucocorticoid therapy was 100%. The follow-up time was 12 months, and one patient experienced multiple recurrences in the course of the disease. ConclusionType 1 AIP is the local manifestation of IgG4-associated disease in the pancreas, which often occurs in middle-aged and elderly men, and most patients are complicated by extrapancreatic lesions. Glucocorticoid therapy is effective and most patients have good prognosis. Recurrence often occurs in the case of no standard or long-term glucocorticoid therapy.
【关键字】:胰腺炎; 免疫球蛋白G; 糖皮质激素类
【Key words】:pancreatitis; immunoglobulin G; glucocorticoids
【引证本文】:MO X, GAO RP, NIU JQ. Clinical features of type 1 autoimmune pancreatitis: an analysis of 13 cases[J]. J Clin Hepatol, 2018, 34(3): 535-539. (in Chinese)
莫雪, 高润平, 牛俊奇. 1 型自身免疫性胰腺炎 13 例临床分析[J]. 临床肝胆病杂志, 2018, 34(3): 535-539.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号