自身免疫性胰腺炎的激素治疗

Corticosteroid therapy for autoimmune pancreatitis

自身免疫性胰腺炎(AIP)是一种由自身免疫介导的特殊类型慢性胰腺炎,有其独特的影像学、血清学及组织病理特征。目前国际指南将AIP分为Ⅰ型和Ⅱ型。研究表明激素对AIP具有较好疗效,且指南将口服糖皮质激素作为无禁忌证患者的首选治疗方案。但是,目前关于初治激素的用量及复发后治疗方案的选择仍无一致的推荐。故综合目前的研究进展及指南推荐,从AIP初治患者的选择及治疗、复发患者的治疗方面阐述目前关于AIP治疗方案的选择。

Autoimmune pancreatitis（ AIP） is a special type of autoimmune-mediated chronic pancreatitis and has unique imaging,serological,and histopathological features. According to current international guidelines,AIP is classified into type I and type II. Studies have shown that glucocorticoids have a good clinical effect in the treatment AIP,and the guidelines recommend oral glucocorticoids as the preferred treatment regimen for patients without contraindications. However,no consensus has been reached on initial dosage of glucocorticoids and treatment regimens after recurrence. Therefore,with reference to recent research advances and recommendations in guidelines,this article elaborates on the selection of treatment regimens for AIP from the aspects of the selection and treatment of previously untreated AIP patients and the treatment of patients with recurrence.