不同剂量激素对自身免疫性胰腺炎免疫球蛋白水平的影响及其临床疗效

Effects of different doses of hormones on immunoglobulin level in autoimmune pancreatitis and its clinical significance

目的探讨不同剂量激素对自身免疫性胰腺炎免疫球蛋白水平的影响以及临床疗效。方法选取我院2015年10月—2017年10月收治的自身免疫性胰腺炎患者90例,按给药剂量的不同分为A、B、C 3组各30例,其中A组患者给予糖皮质激素泼尼松低剂量20 mg/d治疗;B组患者给予中剂量30 mg/d治疗;C组患者给予高剂量,初始剂量为40 mg/d治疗。比较患者免疫球蛋白水平、肝功能以及影像学检查结果。结果治疗后,3组患者IgG4、γ-球蛋白、AST以及ALT水平均明显下降,差异显著(P<0.05),但3组间比较差异无显著性意义(P>0.05);治疗后,3组患者胰头、胰体以及胰尾大小均明显下降,差异显著(P<0.05),但3组间比较差异无显著性意义(P>0.05)。结论三种剂量下糖皮质激素治疗自身免疫性胰腺炎患者均可改善免疫球蛋白水平,其中低剂量糖皮质激素可以获得与高、中剂量相仿的效果。

Objective To investigate the effects of different doses of hormones on immunoglobulin level in autoimmune pancreatitis and its clinical efficacy. Methods 90 patients with autoimmune pancreatitis treated in our hospital from October 2015 to October 2017 were divided into 30 cases of A,B and C three,of which group A patients were given low dose 20 mg/d therapy for corticosteroid,and group B patients were treated with medium dose group 30 mg/d treatment;group C patients were given high dosage,given high dose,given to group C. The initial dose was 40 mg/d.The immunoglobulin level,liver function and imaging findings were compared. Results After treatment,the levels of IgG4,r-globulin,AST and ALT were significantly decreased in the three groups（P〈0.05）,but there was no significant difference between the three groups（P〉0.05）.After treatment,the pancreatic head,the body of pancreas and the tail of the pancreas were significantly decreased in the three groups（P〈0.05）,but the ratio of the three groups was compared.There was no significant difference in the difference between the two groups（P〉0.05）.Conclusion The level of immunoglobulin can be improved by three doses of glucocorticoid in patients with autoimmune pancreatitis,and lowdose corticosteroids can achieve the same effect as high and medium dose.