复发性急性胰腺炎临床和磁共振影像特征风险模型初探  

Preliminary study on risk model of clinical and MRI features of recurrent acute pancreatitis

作　　者：唐玲玲 黄小华[1] 刘念[1] 胡云涛[1] 方杰 TANG Lingling;HUANG Xiaohua;LIU Nian;HU Yuntao;FANG Jie(Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Radiology,the Second Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院放射科,南充637000 [2]川北医学院第二附属医院放射科,南充637000

出　　处：《磁共振成像》2021年第8期27-32,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：四川省科技计划项目(编号:2020088);四川省卫生健康科研课题(编号:19PJ203);南充市市校合作项目(编号:19SXHZ0255,19SXHZ0429)。

摘　　要：目的通过探讨初发急性胰腺炎(acute pancreatitis,AP)和复发性急性胰腺炎(recurrent acute pancreatitis,RAP)的临床特征及MRI特征,建立RAP的临床影像特征风险模型,为RAP的预防及诊治提供依据。材料与方法回顾性收集川北医学院附属医院2015年1月至2017年12月首次诊断AP患者(AP组)132例,复发AP(RAP组)86例,记录两组患者的临床特征及MRI影像学特征,分析AP复发的风险因素。结果RAP组和AP组在发病年龄(P=0.001)、性别(P<0.001)、高脂血症发生率(P<0.001)方面差异均有统计学意义,在饮酒、胰腺炎生化指标等临床特征方面差异无统计学意义(P>0.05)。两组的胰腺炎严重程度分级(P<0.001)、磁共振严重指数(magnetic resonance severity index,MRSI)评分(P=0.001)、并发症分类(P=0.012)、胰胆管汇合类型(P=0.003)及汇合夹角(P<0.001)差异均有统计学意义,而胆道结石发生率差异无统计学意义(P>0.05)。Logistic回归分析临床特征和影像特征显示,男性患者、V型及B-P型汇合、胰胆管夹角、高脂血症及轻中度首发AP是RAP的危险因素,发病年龄是RAP的保护因素。结论MRI特征联合临床特征可预测急性胰腺炎的复发,能够为RAP的预防及诊治提供依据。Objective:To investigate the clinical and MRI risk factors of the recurrence of acute pancreatitis(AP),and to establish the risk model of clinical imaging features of recurrent acute pancreatitis(RAP),so as to provide the basis for the prevention,diagnosis and treatment of RAP.Materials and Methods:A total of 132 patients with AP diagnosed for the first time(AP group)and 86 patients with recurrent AP(RAP group)in the Affiliated Hospital of North Sichuan Medical College from January 2015 to December 2017 were retrospectively collected.The clinical characteristics and MRI imaging data of the two groups were recorded,and the risk factors of the recurrence of AP were analyzed.Results:There were significant differences in the ratio of age(P=0.001),gender(P<0.001)and incidence of hyperlipidemia(P<0.001)between the RAP group and AP group.There was no significant difference in the ratio of drinking,biochemical indexes of pancreatitis between the two groups(all P>0.05).The severity of pancreatitis(P<0.001),MRSI(P=0.001),complication classification(P=0.012),type of pancreaticobiliary junction(P=0.003)and angle of pancreaticobiliary junction(P<0.001)were statistically different between the two groups.There was no significant difference in the incidence of bile duct stones(P>0.05).Logistic regression analysis showed that male patients,V-type and B-P-type junction,pancreaticobiliary angle,hyperlipidemia and first-episode of AP as mild or moderate severe were risk factors for RAP,and age was protective factor for RAP.Conclusions:MRI features combined with clinical features can predict the recurrence of acute pancreatitis,which can provide the basis for the prevention,diagnosis and treatment of RAP.

关 键 词：急性胰腺炎 磁共振成像 临床特征 

分 类 号：R445.2[医药卫生—影像医学与核医学] R576[医药卫生—诊断学]