协和医学杂志

2015, v.6(02) 89-95

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北京协和医院346例慢性胰腺炎人口学特征、病因变迁及临床特点
Demographic Features,Etiology Trend and Clinical Characteristics of Chronic Pancreatitis:A Respective Study of 346 Cases in Peking Union Medical College Hospital

赖雅敏;郭涛;丁辉;吕红;杨红;杨爱明;李景南;韦婷;王辉;张岳;钱家鸣;
LAI Ya-min;GUO Tao;DING Hui;Lü Hong;YANG Hong;YANG Ai-ming;LI Jing-nan;WEI Ting;WANG Hui;ZHANG Yue;QIAN Jia-ming;Departemnt of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Department of Gastroenterology,Henan Provincial People's Hospital;Department of Gastroenterology,Nanning People's Hospital of Guangxi Zhuang Autonomous Region;Department of Gastroenterology,Xinle People's Hospital;China Press of Traditional Chinese Med

摘要(Abstract):

目的探讨慢性胰腺炎(chronic pancreatitis,CP)的人口学特征、发病病因变迁和临床特点。方法回顾性分析1983年1月至2008年12月北京协和医院346例CP住院患者的资料,总结其人口学特征、临床表现、病因和并发症情况。结果 346例CP患者中,男267例,女79例,男∶女比例为3.38∶1,发病年龄(44.34±15.88)岁。民族分布以汉族为最多(94.80%,328/346),职业分布以干部为最多(32.08%,111/346)。CP患者无论是患者总数还是入院人数占同期住院患者人数的比例均呈现快速增长的趋势。酒精(40.17%)和胆石症(41.04%)是最常见的CP病因因素。不同病因类型的CP均有明显的增长,以酒精性CP增长尤为显著,平均年增长率为108.7%。84.39%(292/346)的患者有腹痛症状,56.07%(194/346)的患者有体重下降,24.86%(86/346)的患者有黄疸,均为梗阻性黄疸。CP并发症以糖尿病最为多见,占25.14%(87/346)。糖尿病和脂肪泻出现的病程中位时间分别在发病后1.00年和280.03个月,自身免疫性胰腺炎出现糖尿病早于特发性胰腺炎(P=0.020)。结论我国CP发病人数在快速增长,酒精性CP的增长速度超过胆源性CP。腹痛与消瘦是CP最常见症状,糖尿病是CP最常见并发症。建立CP病例资料库并进行有序随诊将有助于总结CP流行病学规律和提高诊治经验。
Objective To investigate the demographic features,etiology and clinical characteristics of chronic pancreatitis( CP). Methods We retrospectively analyzed the records of 346 CP cases hospitalized in PekingUnion Medical College Hospital during the period of January 1983 to December 2008,summarizing the demographic features,clinical manifestations,causes of disease,and complications of these patients. Results The 346 CP cases included 267 males and 79 females( M / F ratio = 3. 38 ∶ 1). The mean age of onset was( 44. 34 ± 15. 88)years. Most of the patients were Han Chinese( 94. 80%,328 /346),and a large proportion were cadres( 32. 08%,111 /346). Both the number of CP cases and its proportion in the total number of inpatients in the hospital increased rapidly. Alcohol( 40. 17%) and cholelithiasis( 41. 04%) were the most common risk factors of CP. CP of different etiologies had all increased,especially alcoholic CP,growing by an mean annual rate of108. 7%. 84. 39%( 292 /346) of the patients presented with abdominal pain,56. 07%( 194 /346) had weight loss,24. 86%( 86 /346) had jaundice( all obstructive). Diabetes( 25. 14%,87 /346) was the most common complication. The median time of CP onset to occurrence of diabetes and fatty diarrhea were 1. 00 year and280. 03 months,respectively. Diabetes occurred earlier in patients with autoimmune pancreatitis than those with idiopathic pancreatitis( P = 0. 020). Conclusions The incidence of CP is growing rapidly in China,with alcoholic CP increasing faster than biliary CP. The most common symptoms of CP are abdominal pain and weight loss,while the most common complication is diabetes. A patient database and regular follow-up visits could contribute to better understanding of epidemiological patterns of CP and improvement of its diagnosis and treatment.

关键词(KeyWords): 慢性胰腺炎;流行病学;酒精性慢性胰腺炎;胆源性慢性胰腺炎;自身免疫性胰腺炎
chronic pancreatitis;epidemiology;alcoholic chronic pancreatitis;biliary chronic pancreatitis;autoimmune pancreatitis

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作者(Author): 赖雅敏;郭涛;丁辉;吕红;杨红;杨爱明;李景南;韦婷;王辉;张岳;钱家鸣;
LAI Ya-min;GUO Tao;DING Hui;Lü Hong;YANG Hong;YANG Ai-ming;LI Jing-nan;WEI Ting;WANG Hui;ZHANG Yue;QIAN Jia-ming;Departemnt of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Department of Gastroenterology,Henan Provincial People's Hospital;Department of Gastroenterology,Nanning People's Hospital of Guangxi Zhuang Autonomous Region;Department of Gastroenterology,Xinle People's Hospital;China Press of Traditional Chinese Med

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