CAJ | 학술논문

目的回顾性分析自身免疫性胰腺炎(AIP)的实验室、病理学及影像学表现,以便早期诊断AIP并进行治疗.方法选取2007年6月至2009年6月我院收治、诊断明确及资料完整的AIP患者11例.所有患者均检测血常规、肿瘤指标、血淀粉酶、自身抗体等指标,并行腹部CT和B超检查.结果实验室检查:血淀粉酶和肝酶增高5例,高胆红素血症4例,高球蛋白血症3例;肿瘤指标:6例患者CA199升高,平均值为78.4 U/ml;影像学检查:11例患者均有胰腺肿大.4例患者给予药物治疗,3个月后复查胰腺体积恢复正常,胰管及胆管未见狭窄或扩张;7例患者术后病理证实胰腺内大量纤维组织增生,淋巴细胞、浆细胞浸润,并见淋巴滤泡形成,其中2例术后6～12个月确诊为干燥综合征和类风湿关节炎,予糖皮质激素及免疫抑制剂治疗后症状消失.结论 AIP是一种特殊类型的慢性胰腺炎,具有特征性的实验室、影像学及组织学特点.如诊断明确,糖皮质激素及免疫抑制剂治疗有效.
목적 회고성분석자신면역성이선염(AIP)적실험실、병이학급영상학표현,이편조기진단AIP병진행치료.방법 선취2007년6월지2009년6월아원수치、진단명학급자료완정적AIP환자11례.소유환자균검측혈상규、종류지표、혈정분매、자신항체등지표,병행복부CT화B초검사.결과 실험실검사:혈정분매화간매증고5례,고담홍소혈증4례,고구단백혈증3례;종류지표:6례환자CA199승고,평균치위78.4 U/ml;영상학검사:11례환자균유이선종대.4례환자급여약물치료,3개월후복사이선체적회복정상,이관급담관미견협착혹확장;7례환자술후병리증실이선내대량섬유조직증생,림파세포、장세포침윤,병견림파려포형성,기중2례술후6～12개월학진위간조종합정화류풍습관절염,여당피질격소급면역억제제치료후증상소실.결론 AIP시일충특수류형적만성이선염,구유특정성적실험실、영상학급조직학특점.여진단명학,당피질격소급면역억제제치료유효.
Objective To summarize the laboratory, pathologic and imaging characteristics of patients with autoimmune pancreatitis (AIP) retrospectively for early diagnosis and treatment. Methods Eleven AIP patients were selected in our hospital from 2007 to 2009. Laboratory parameters including complete blood count, tumor markers, hemodiastase and autoantibodies were tested. Abdominal ultrasonography and computerized tomography (CT) scanning were also performed. Results Five patients had elevated hemodiastase and liver enzymes, four patients had hyperbilirubinemia and three patients had hyperglobulinemia. Increased serum CA199 levels (mean 78.4 U/ml) were found in six patients. All of the 11 patients had enlarged pancreas on imaging. Four cases were treated with three months of drug therapy. After the treatment, the pancreas volumereturned to normal size, pancreatic duct and bile duct became normal in size. Seven cases received surgical operation. Pathology examination showed fibrous tissue and folliculus lymphaticus formation in the pancreas,with a large number of lymphocytes and plasma cells infiltration. Two of seven cases were diagnosed with Sj(o)gren's syndrome and rheumatoid arthritis after being followed-up for six to twelve months post-operation.Their symptoms relieved after corticosteroid and immunosuppressive therapy. Conclusion AIP is a special type of chronic pancreatitiswith characteristic laboratory, imaging and histological features. Glucocorticoid and immunosuppressive agents therapy are effective for AIP.