42例青少年慢性胰腺炎的病因及临床特征分析  

Chronic pancreatitis in children： etiologies and clinical characteristics in 42 patients

作　　者：王伟[1] 李兆申[1] 廖专[1] 王洛伟[1] 施新岗[1] 孙振兴[1] 刘枫[1] 高军[1] 

机构地区：[1]第二军医大学长海医院消化内科,上海200433

出　　处：《中华胰腺病杂志》2008年第1期6-8,共3页Chinese Journal of Pancreatology

摘　　要：目的探讨青少年慢性胰腺炎（CP）的病因及临床特征。方法依据2002年亚太共识报告中提出的CP诊断标准，回顾分析1997年1月至2006年8月间住院治疗的42例青少年CP患者的病因、临床表现及影像学资料。结果42例青少年CP患者占同期住院CP患者的9．84％，男、女各21例，平均住院年龄15．1岁，平均首发年龄为11．8岁；发病时间超过2年者25例（59．5％）；首发到确诊时间超过2年者24例（57．1％）。病因中以特发性慢性胰腺炎（ICP）为主（27例，64．3％），其次为胆道疾病和胰腺分裂等。轻、中度腹痛为主要症状，23例（54．8％）患者入院前腹痛发作4次以上，39例（92．9％）患者至少有一次“AP”发作。ERCP、CT、MRI（或MRCP）、腹部B超的阳性发现率分别为100％（37／37）、92．9％（13／14）、76．9％（20／26）和78．4％（29／37），以病理学诊断或ERCP所见为“金标准”，CT、MRI（或MRCP）、腹部B超显示胰管改变的阳性率分别为74．1％、74．1％和51．4％；显示胰腺钙化或胰管结石的阳性率分别为87．5％、61．5％和45．4％。结论青少年CP的首要病因为ICP，对反复发作的轻中度腹痛尤其是有“AP”病史者，应考虑CP的存在，辅助检查以MRI（或MRCP）和CT为优。Objective To investigate the etiologies and clinical characteristics of chronic pancreatitis （CP） in children. Methods Clinical data including the etiologies, clinical characteristics and radiological records of children with CP treated at our hospital from January 1997 to August 2006 were reviewed. The diagnosis of CP was based on the Asia Pacific consensus report. Result A total of 42 medical records of children with CP, including 21 males and 21 females, with a mean age at admission 15.1 years, a mean age at first onset 11.8 years were reviewed. The proportion of mean duration over 2 years of symptoms prior to diagnosis was 59.5% （25 of 42）. Of the 42 patients, 24 （57.1%） were diagnosed beyond two years. The commonest etiologies were idiopathic （64. 3%）, anatomical anomalies, biliary diseases, etc. The main symptom consisted of mild to moderate abdominal pain, 54.8% patients had multiple （ ≥ 4 ） episodes of abdominal pain, and 92.9% had at least one episode of ＂ acute pancreatitis＂. Taken pathologic evidence or ERCP findings as gold standard, the positive diagnostic rates of CT and MRCP （or MRI）, abdominal ultrasound, were 74. 1%, 74. 1% and 51.4%, respectively; but the positive rate for intraductal stones or pancreatic calcification in our series were 87.5%, 61.5% and 45.4%, respectively. Conclusions The main etiological factor of Chinese children with CP was idiopathic. CT and MRCP （or MRI） should be the imaging test of choice in the evaluation of children suspected of CP, especially those who had mild to moderate abdominal pain and those who had at least one episode of ＂AP＂.

关 键 词：胰腺炎 慢性 青少年 病因学 疾病特征 回顾性研究 

分 类 号：R576[医药卫生—消化系统] R657.4[医药卫生—内科学]