自身免疫性胰腺炎诊治进展

The progress of diagnosis and treatment of autoimmune pancreatitis

自身免疫性胰腺炎(AIP)是一种罕见类型的胰腺炎。其诊断主要根据对胰腺实质和胰管成像、血清学检测、其他器官受累情况、胰腺组织病理学和对类固醇激素治疗的反应5个方面的综合评估。在治疗上,AIP的标准治疗方法是口服糖皮质激素。利妥昔单抗也被建议用于复发的Ⅰ型AIP的诱导缓解和维持治疗。在特定的病人中,免疫调节剂也可用于维持缓解病情。此外,包括生物制剂等一些副反应更少的疗法可能成为类固醇激素和免疫抑制剂的有效替代方案。

Autoimmune pancreatitis(AIP)is a rare type of pancreatitis.At present,the diagnosis of AIP is often based on pancreatic histomorphology,changes in pancreatic parenchyma and biliary tree using imaging methods,serology,the presence of other organ involvement,and positive response to corticosteroids.The standard treatment for AIP is oral administration of corticosteroids.Rituximab has also been proposed for induction of remission and maintenance therapy against relapsed AIP-1.In selected patients,immunomodulators may also be used to maintain remission.In addition,other treatment options,including biological agents such as anti-tumor necrosis factor therapy,which may become effective alternatives to steroids and immunosuppressive agents thereby providing patients with a treatment modality with fewer side effects.