自身免疫性胰腺炎临床症状及血清学特征分析

Clinical symptoms and serological features of autoimmune pancreatitis

目的回顾性分析自身免疫性胰腺炎(AIP)患者的临床症状及血清学特征,提高对AIP的早期识别。方法选取2003年1月至2011年10月中国医科大学附属盛京医院外科收治的术后病理符合AIP的患者36例,总结AIP患者的临床表现、血清学等特点。结果 AIP具有以下特点:(1)中老年起病多见,可急性或隐匿起病,体重下降多见;(2)腹痛、腹胀、黄疸最常见,易合并胆系病变,可合并糖尿病及心脏传导障碍(尤其右束支);(3)血清学为肝胆胰酶及肿瘤标志物CA199可升高,γ-谷氨酰转肽酶明显升高具有特征性。结论 AIP是一种特殊类型的慢性胰腺炎,具有特征性的临床症状及血清学改变。

Objective To retrospectively analyze the clinical symptoms and serological features of antoimmune panereatitis （AIP） , thus promoting the early identification. Methods We enrolled 36 patients admitted to the department of surgery, Shengjing Hospital of China Medical University, between January 2003 and October 2011, whose pathological findings were consistent with AIP. The clinical manifestations and serology of AIP were analyzed. Results Patients with AIP were frequently middle-aged or elderly, and had an acute or insidious onset that was often associated with loss of weight. Their most frequent clinical manifestations included abdominal pain, abdominal distension and jaundice that can readily complicate with biliary tract disorders. It is likely that diabetes and cardiac conduction disturbance （ particularly right bundle branch） may also be noted. Elevated level of hepatic, biliary and pancreatic enzymes and CA19-9, a tumor biomarker, may be the charac- teristic features of serology, particularly the considerably increased level of -y-glutamyftranspeptidase. Conclusion AIP is a unique type of chronic pancreatitis featured by distinctive clinical and serological characteristics.