IgG4相关自身免疫性胰腺炎临床及超声内镜特征分析  

Clinical and endoscopic ultrasound features of IgG4-related autoimmune pancreatitis

作　　者：孙红翼 柴宁莉[2] 李金平 李惠凯[2] 王祥耀 茹楠 令狐恩强[2] Sun Hongyi;Chai Ningli;Li Jinping;Li Huikai;Wang Xiangyao;Ru Nan;Linghu Enqiang(Nankai University School of Medicine,Tianjin 300071,China;Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]南开大学医学院,天津300071 [2]解放军总医院第一医学中心消化内科医学部,北京100853

出　　处：《中华消化内镜杂志》2024年第2期127-130,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的分析弥漫型与局灶型IgG4相关自身免疫性胰腺炎(IgG4-related autoimmune pancreatitis,IgG4-AIP)的临床及超声内镜检查(endoscopic ultrasonography,EUS)结果差异。方法回顾性收集2011年9月至2022年4月于解放军总医院行EUS并临床诊断为IgG4-AIP的患者资料,对一般临床资料、EUS特征、术后病理等相关资料进行描述,获得特征差异。结果共纳入40例患者,年龄(60.03±10.87)岁,男性多见(85.0%,34/40)。所有患者行EUS,其中28例患者行EUS引导下细针穿刺。40例患者中,29例(72.5%)为弥漫型,11例(27.5%)为局灶型。弥漫型患者中腹痛[65.5%(19/29)比18.2%(2/11),χ^(2)=5.393,P=0.020]和胆管壁增厚[51.7%(15/29)比9.1%(1/11),χ^(2)=4.394,P=0.036]更多见,局灶型患者中主胰管扩张[45.5%(5/11)比10.3%(3/29),χ^(2)=4.146,P=0.042]更多见,且病灶位置以胰头最常见(90.9%,10/11)。两组在慢性胰腺炎实质改变上差异无统计学意义[34.5%(10/29)比27.3%(3/11),χ^(2)=0.003,P=0.955]。结论弥漫型和局灶型AIP在腹痛及胆胰管病变中具有一定差异,慢性胰腺炎特征在两组中均未见高水平表达,这对临床实践中的AIP分型有提示作用。ObjectiveTo analyze the differences in clinical and endoscopic ultrasonography(EUS)findings between diffuse and focal IgG4-related autoimmune pancreatitis(IgG4-AIP).MethodsData of patients diagnosed as having IgG4-AIP who underwent EUS at Chinese PLA General Hospital from September 2011 to April 2022 were retrospectively collected.General clinical data,EUS features,and postoperative pathology were analyzed for characteristic differences.ResultsA total of 40 patients were included in the study,60.03±10.87 years old,a higher proportion of males(85.0%,34/40).All patients underwent EUS,and 28 underwent EUS-guided fine-needle aspiration.Among the 40 patients,29(72.5%)had diffuse type and 11(27.5%)had focal type.Abdominal pain[65.5%(19/29)VS 18.2%(2/11),χ^(2)=5.393,P=0.020]and thickening of the bile duct wall[51.7%(15/29)VS 9.1%(1/11),χ^(2)=4.394,P=0.036]were more common in the diffuse type,while main pancreatic duct dilation[45.5%(5/11)VS 10.3%(3/29),χ^(2)=4.146,P=0.042]was more common in the focal type,with the lesion most commonly located in the pancreatic head(90.9%,10/11).There was no significant difference in the presence of chronic pancreatitis parenchymal changes between the two groups[34.5%(10/29)VS 27.3%(3/11),χ^(2)=0.003,P=0.955].ConclusionThere are certain differences in abdominal pain and biliary and pancreatic duct lesions between diffuse and focal AIP.The high expression of chronic pancreatitis characteristics is not observed in either group,which provides clues for the classification of AIP in clinical practice.

关 键 词：胰腺炎 自身免疫性 IgG4相关自身免疫性胰腺炎 临床特征 超声内镜 

分 类 号：R576[医药卫生—消化系统]