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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

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

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文章导航 > 协和医学杂志  > 2015 >  6(2): 89-95
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. 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[J]. 协和医学杂志, 2015, 6(2): 89-95. doi: 10.3969/j.issn.1674-9081.2015.02.003
引用本文: 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. 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[J]. 协和医学杂志, 2015, 6(2): 89-95. doi: 10.3969/j.issn.1674-9081.2015.02.003
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Ya-min LAI, Tao GUO, Hui DING, Hong Lü, Hong YANG, Ai-ming YANG, Jing-nan LI, Ting WEI, Hui WANG, Yue ZHANG, Jia-ming QIAN. Demographic Features, Etiology Trend and Clinical Characteristics of Chronic Pancreatitis: A Respective Study of 346 Cases in Peking Union Medical College Hospital[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(2): 89-95. doi: 10.3969/j.issn.1674-9081.2015.02.003
Citation: Ya-min LAI, Tao GUO, Hui DING, Hong Lü, Hong YANG, Ai-ming YANG, Jing-nan LI, Ting WEI, Hui WANG, Yue ZHANG, Jia-ming QIAN. Demographic Features, Etiology Trend and Clinical Characteristics of Chronic Pancreatitis: A Respective Study of 346 Cases in Peking Union Medical College Hospital[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(2): 89-95. doi: 10.3969/j.issn.1674-9081.2015.02.003
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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

doi: 10.3969/j.issn.1674-9081.2015.02.003
  • 1.

    中国医学科学院 北京协和医学院 北京协和医院消化内科, 北京 100730

  • 2.

    河南省人民医院消化内科, 郑州 450003

  • 3.

    广西壮族自治区南宁市人民医院消化内科, 南宁 530000

  • 4.

    河北省新乐市人民医院消化内科, 河北新乐 050700

  • 5.

    中国中医药出版社, 北京 100013

详细信息
    通讯作者:

    钱家鸣 电话:010-69155019, E-mail:qianjiaming1957@126.com

  • 中图分类号: R576

Demographic Features, Etiology Trend and Clinical Characteristics of Chronic Pancreatitis: A Respective Study of 346 Cases in Peking Union Medical College Hospital

  • 1.

    Departemnt of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Gastroenterology, Henan Provincial People's Hospital, Zhengzhou 450003, China

  • 3.

    Department of Gastroenterology, Nanning People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530000, China

  • 4.

    Department of Gastroenterology, Xinle People's Hospital, Xinle, Hebei 050700, China

  • 5.

    China Press of Traditional Chinese Medicine, Beijing 100013, China

More Information

    摘要
  • 摘要:   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  目的  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。
    Abstract:   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 Peking Union 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 of 108.7%. 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 and 280.03 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.
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  • 图  1  北京协和医院1983—2008年慢性胰腺炎患者入院例数及其占同期总住院患者比例随时间的变化趋势

    下载: 全尺寸图片 幻灯片

    图  2  北京协和医院1983—2008年慢性胰腺炎患者的发病年龄分布

    下载: 全尺寸图片 幻灯片

    图  3  慢性胰腺炎患者糖尿病(A)和脂肪泻(B)发病时间的生存分析

    下载: 全尺寸图片 幻灯片

    图  4  不同病因类型慢性胰腺炎出现糖尿病的时间

    病因类型：1.酒精性胰腺炎；2.胆源性胰腺炎；3.自身免疫性胰腺炎；4.其他原因(以特发性胰腺炎为主)

    下载: 全尺寸图片 幻灯片

    图  5  不同病因类型慢性胰腺炎出现脂肪泻的时间

    病因类型：1.酒精性胰腺炎；2.胆源性胰腺炎；3.自身免疫性胰腺炎；4.其他原因(以特发性胰腺炎为主)

    下载: 全尺寸图片 幻灯片

    表  1  慢性胰腺炎不同病因类型随年代的变化

    病因 年份[例(%)] 总计
    [例(%)]    		 平均年增长率
    (%)
    1983—1987 1988—1992 1993—1997 1998—2002 2003—2008
    胆源性 6(37.5) 8(42.1) 14(32.6) 28(30.4) 58(33.0) 114(32.95) 78.9
    酒精性 4(25.0) 8(42.1) 8(18.6) 29(31.5) 50(28.4) 99(28.61) 108.7
    自身免疫 0(0) 0(0) 0(0) 4(4.3) 18(10.2) 22(6.36) 350.0
    其他 6(37.5) 3(15.8) 21(48.8) 31(33.7) 50(28.4) 111(32.08) 164.7
    总计 16(100) 19(100) 43(100) 92(100) 176(100) 346(100) 87.6
    下载: 导出CSV
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  • 收稿日期:  2014-12-10
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