急性胰腺炎的临床特征分析

The clinical features of acute pancreatitis in 10 cities in Shandong Province

目的 全面了解和探讨急性胰腺炎 (AP)的病因学变化和发病情况。方法 回顾分析1992～ 2 0 0 2年间山东省 10地市确诊的 14 71例AP患者 ,患者资料均以统一标准格式进行记录。结果 14 71例AP中男性 85 4例 ,女性 6 17例 ,平均年龄 4 3 3岁 ,轻症 12 80例 ,重症 191例。AP最常见的三大病因为胆石症 (2 0 2 % )、酒精 (17 3% )和暴饮暴食 (12 4 % ) ,其他依次为胆系感染(5 6 % )和高脂血症 (2 3% )等。不明原因者占 36 1%。在沿海地区 ,胆石症是AP的主要病因 ,而内陆地区酒精因素居首位。在男性患者中酒精因素 (2 7 4 % )居首位 ,胆石症为 14 3% ;在女性患者中胆石症 (2 8 4 % )居首位 ,酒精因素为 3 2 %。AP的并发症按其出现频率依次为胰腺假性囊肿、腹腺炎和腹水、肺部感染、多脏器功能衰竭、2型糖尿病、一过性高血糖、消化道出血、休克、急性呼吸窘迫综合征和肝功能损伤等。结论 胆石症、酒精和暴饮暴食是AP最常见的三大病因 ,其中男性患者中酒精因素居首位 ,不明原因者仍占相当比例 。

Objective To investigate and obtain a more comprehensive view of the etiology and clinical features of acute pancreatitis (AP) in Shandong Province. Methods 1471 cases admitted to hospital for AP were studied and collected from the ten cities of Shandong Province from January 1992 to December 2002 retrospectively . Data of each enrolled patient was recorded in a standardized form. Results(In the) 1471 patients, the ratio of male: female was 854:617, and also the mean age of them and the rage was 43.3 and from 13-82 years old. 1280 had mild AP, and 191 had sever AP. Cholelithiasis (20.2%), alcohol (17.3%) and diet-induced (12.4%) were the most frequent etiologic factors, followed by biliary tract infections (5.6%),hyperlipemia (2.3%),other factors (5.1%). But in about 36.1% cases ,the etiology of AP still remains unexplained. In coastal regions, cholelithiasis is the most frequent factor but in interior regions alcohol ranked first. In male, a small predominance of alcohol over cholelithiasis was seen (27.4 vs.14.3%, P<0.01); and in female, there was a clear predominance of cholelithiasis over alcohol (28.4 vs. 3.2%, P<0.01). The complications of AP were pancreatic pseudocyst, ascites and peritonitis, pulmonary infections, multiple organ failure, diabetes mellitus-2 and shock, etc. according to their frequencies. Conclusions Cholelithiasis, alcohol and diet-induced factor were main etiologic factors in Shandong Province, whereas cholelithiasis alone predominated in the females. In about 36.1% cases, the etiology remains unknown. So that more attention should be paid to study the etiology of AP.