慢性胰腺炎脂肪泻及其危险因素分析  

Steatorrhea in patients with chronic pancreatitis and the risk factors

作　　者：林金欢 杜婷婷[1] 胡良皞[1] 廖专[1] 叶博[1] 李白容[1] 郑兆泓 季钧淘[1] 王丹[1] 张菂[1] 毕雅维 曾祥鹏[1] 李兆申[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》2016年第2期110-114,共5页Chinese Journal of Pancreatology

基　　金：基金项目：国家自然科学基金（81100316、81422010、81300355和81470883）;上海市晨光计划（12CG40）;上海市卫生局青年基金（AB83070002011019）;上海市青年医师培训计划（AB83030002015034）

摘　　要：目的探讨慢性胰腺炎（CP）患者脂肪泻发生情况及其危险因素。方法收集2000年1月至2008年12月在上海长海医院消化内科住院治疗的CP患者资料，用Kaplan-Meier法计算脂肪泻累积发生率，脂肪泻危险因素采用单因素分析及Cox比例风险模型逐步回归分析。结果591例CP患者随访率为85.62%，平均随访时间（10.6±6.3）年。发生脂肪泻152例（25.72%），男女比例为3.61∶1，病因以特发性慢性胰腺炎（ICP）为主，有120例（78.95%）。CP确诊后1、5、10年的脂肪泻累积发生率为20%、26%、29%，男女性别的差异无统计学意义（P＝0.143）。通过单因素分析筛选出发病年龄、确诊年龄、性别、酗酒、吸烟、遗传因素、胆管狭窄、胰腺假性囊肿、腹痛9个变量纳入Cox比例风险模型分析，其中发病年龄（RR＝1.055，P＝0.035）、胆管狭窄（RR＝1.943，P＝0.041）和腹痛（RR＝0.419，P＝0.006）为CP患者脂肪泻的独立危险因素。结论超过四分之一的CP患者在病程中发生脂肪泻，发病年龄大、胆管狭窄、腹痛为发生脂肪泻的独立危险因素。Objective To investigate the occurrence and risk factors of steatorrhea in chronic pancreatitis （CP） patients. Methods Data of CP patients admitted to Department of Gastroenterology in Changhal Hospital from January 2000 to December 2008 were retrospectively analyzed. The cumulative rate of steatorrhea was calculated by using the Kaplan-Meier method. Univariate analysis and multivariate Cox proportional hazards regression model was performed to detect risk factors for steatorrhea. Results A total of 591 CP patients were included and 85.62% of them were followed up with an average duration of （ 10.6 ± 6.3 ） years. There were 152 （25.72%） patients who had steatorrhea and the ratio of men to women was 3.61： 1. The main cause for steatorrhea was ICP and there were 120 ICP patients who had steatorrhea. The cumulative rates of steatorrhea at 1, 5 and 10 years after CP diagnosis were 20%, 26% and 29%, respectively, and no significant differences were detected on the incidence in male and female patients （P =0. 143 ）. Nine variables identified from univariate analyses were involved in Cox proportional hazards regression model were age of CP onset, age of CP diagnosis, gender, drinking, smoking, genetic factors, biliary stenosis, pancreatic pseudocyst and abdominal pain. The results demonstrated that age of CP onset （ RR = 1. 055, P = 0. 035 ）, biliary stenosis （ RR = 1. 943, P = 0. 041 ） and abdominal pain （ RR = 0.419, P =0. 006） were the independent risk factors for steatorrhea in CP patients. Conclusions More than 25% of CP patients developed steatorrhea and old age of onset, biliary stenosis and abdominal pain were three independent risk factors for steatorrhea.

关 键 词：胰腺炎 慢性 脂肪泻 危险因素 

分 类 号：R576[医药卫生—消化系统]