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1型自身免疫性胰腺炎13例临床分析

莫雪 高润平 牛俊奇

临床肝胆病杂志2018,Vol.34Issue(3):535-539,5.
临床肝胆病杂志2018,Vol.34Issue(3):535-539,5.DOI:10.3969/j.issn.1001-5256.2018.03.017

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

莫雪 1高润平 1牛俊奇1

作者信息

  • 1. 吉林大学第一医院肝病科,长春130021
  • 折叠

摘要

Abstract

Objective To 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. Methods A 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. Results Of all 13 patients,there were 9 male and 4 female patients with a mean age of 60.08 ± 9.47 years. Ma-jor clinical manifestations included jaundice(69.2%),abdominal pain(61.5%),and weight loss(61.5%). The most common organ in-volved was bile duct(46.2%),and 30.8% of the patients had sclerosing cholangitis. Of all patients,23.1% had diabetes. As for serolog-ical 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 amin-otransferases 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. Conclusion Type 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 com-plicated 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.

关键词

胰腺炎/免疫球蛋白G/糖皮质激素类

Key words

pancreatitis/immunoglobulin G/glucocorticoids

分类

医药卫生

引用本文复制引用

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):535-539,5.

临床肝胆病杂志

OA北大核心CSTPCD

1001-5256

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