Ⅰ型自身免疫性胰腺炎的研究  

Research of type Ⅰ autoimmune pancreatitis

作　　者：李凤东[1] 杜雅菊[1] 

机构地区：[1]哈尔滨医科大学附属第二医院消化内科,黑龙江哈尔滨150086

出　　处：《胃肠病学和肝病学杂志》2013年第11期1063-1066,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：自身免疫性胰腺炎(AIP)是自身免疫介导的一种慢性胰腺炎。Ⅰ型AIP是AIP最主要的类型,在慢性胰腺炎患者中约占2%,好发于成年男性。胰腺癌是AIP最主要的鉴别诊断,两者的鉴别依赖于血清学、影像学和组织学检查。血清IgG4水平的升高是最敏感和特异的指标。影像学特征包括胰管不规则狭窄,胰腺弥漫性或局限性肿大,胰腺周围包膜样边缘(capsule-like rim),动态增强扫描晚期可见强化。胰腺的活检或手术切除标本显示弥漫性淋巴细胞、浆细胞浸润,席纹样纤维化,闭塞性静脉炎。Autoimmune pancreatitis （AIP） is a type of chronic pancreatitis characterized by an autoimmune inflammatory process.Type Ⅰ appears to be the most predominant form of AIP,which accounts for 2％ of chronic pancreatitis cases,predominantly affects adult males.Pancreatic cancer is the leading differential diagnosis serological,imaging,and histological examinations.Serologically,an elevated level of IgG4 is the most sensitive and specific index.Imaging features include irregular narrowing of the pancreatic duct,diffuse or local enlargement of the pancreas,a peri-pancreatic capsule-like rim,and enhancement at the late phase of contrast-enhanced images.Biopsy or surgical specimens show diffuse lymphoplasmacytic infiltration containing many IgG4 ＋ plasma cells,storiform fibrosis and obliterative phlebitis.

关 键 词：IGG4 诊断 IGG4相关性疾病 病理学 发病机制 

分 类 号：R576[医药卫生—消化系统]