吸烟对特发性慢性胰腺炎患者临床特征的影响  

Effect of smoking on clinical characteristics of patients with idiopathic chronic pancreatitis

作　　者：王帆 刘雨 蔡亦李 张菂 王丹 胡良皞 李兆申 Wang Fan;Liu Yu;Cai Yili;Zhang Di;Wang Dan;Hu Lianghao;Li Zhaoshen(Department of Gastroenterology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Gastroenterology,General Hospital of Eastern Theater of the Chinese People's Liberation Army,Nanjing 210002,China;Department of Gastroenterology,Naval Medical Center Navy Medical University,Shanghai 200052,China)

机构地区：[1]海军军医大学第一附属医院消化内科,上海200433 [2]中国人民解放军东部战区总医院消化内科,南京210002 [3]海军军医大学海军特色医学中心消化内科,上海200052

出　　处：《中华消化病与影像杂志(电子版)》2025年第2期101-106,共6页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：国家自然科学基金(82270679,82200723,82230018)。

摘　　要：目的分析特发性慢性胰腺炎患者中吸烟者与不吸烟者的临床特征及病程差异,以明确吸烟对特发性慢性胰腺炎患者临床特征的影响。方法前瞻性收集2010年1月至2013年12月间海军军医大学第一附属医院消化内科收治的966例特发性慢性胰腺炎患者的临床资料,根据是否有吸烟史将患者分为吸烟组和不吸烟组,比较两组的临床特征。采用Kaplan-Meier法计算特发性慢性胰腺炎起病后脂肪泻、糖尿病、胰腺假性囊肿、胰腺结石及胆总管狭窄的累计发生率。结果966例特发性慢性胰腺炎患者中吸烟患者274例,不吸烟患者692例。吸烟患者的临床特征与不吸烟患者明显不同,其中慢性胰腺炎发病年龄、确诊年龄、起病时为青少年、主胰管形态、疼痛类型、胰管成功引流、治疗方式、胰管结石和胰腺假性囊肿有显著差异(P均<0.05)。吸烟组患者胰管结石(P=0.002)和胰腺假性囊肿(P<0.001)的发生率显著高于不吸烟组患者。结论吸烟组与不吸烟组特发性慢性胰腺炎患者的临床特征存在显著差异,吸烟组慢性胰腺炎相关并发症发生率更高,并加速胰腺假性囊肿的发生,吸烟可能对特发性慢性胰腺炎患者的临床特征有显著影响。Objective To analyze the clinical characteristics and course differences between smokers and non-smokers in patients with idiopathic chronic pancreatitis,in order to clarify the impact of smoking on the clinical characteristics of patients with idiopathic chronic pancreatitis.Methods Prospective clinical data were collected from 966 patients with idiopathic chronic pancreatitis admitted to the Department of Gastroenterology at the First Affiliated Hospital of Naval Medical University from January 2010 to December 2013.Patients were divided into a smoking group and a non-smoking group based on their smoking history,and their clinical characteristics were compared between the two groups.Kaplan-Meier method was used to calculate the cumulative incidence of steatorrhea,diabetes,pancreatic pseudocysts,pancreatic stones and biliary stricture after the onset of idiopathic chronic pancreatitis.Results Among 966 patients with idiopathic chronic pancreatitis,274 were smokers and 692 were non-smokers.The clinical characteristics of smokers are significantly different from non-smokers,with significant differences in the age of onset,age of diagnosis,adolescent onset,main pancreatic duct morphology,pain type,successful drainage of the pancreatic duct,treatment methods,pancreatic duct stones,and pancreatic pseudocysts(all P<0.05).The incidence of pancreatic duct stones(P=0.002)and pancreatic pseudocysts(P<0.001)in the smoking group was significantly higher than that in the non-smoking group.Conclusion There is a significant difference in the clinical characteristics of patients with idiopathic chronic pancreatitis between the smoking group and the non-smoking group.The smoking group has a higher incidence of complications related to chronic pancreatitis and accelerates the occurrence of pancreatic pseudocysts.Therefore,smoking may have a significant impact on the clinical characteristics of patients with idiopathic chronic pancreatitis.

关 键 词：特发性慢性胰腺炎 吸烟 临床特征 病程 

分 类 号：R576[医药卫生—消化系统]