CAJ | 학술논문

目的：分析并总结我院收治的自身免疫性胰腺炎（ AIP）临床特征及诊治经验。方法回顾性分析2009年至2013年我院收治的13例AIP的临床资料。结果13例AIP中，中位年龄48岁，临床表现主要为上腹疼痛不适，梗阻性黄疸及体重下降。胰腺弥漫性增大及局限性增大各6例，胰体尾假性囊肿及胰腺结石各1例，胰管扩张4例。胰腺外器官受累9例（胆管病变8例、胆囊病变7例、腹膜后纤维化1例、腹腔淋巴结肿大6例、脾静脉变细4例、干燥综合征及溃疡性结肠炎各1例）。7例行血免疫标志物检查，IgG升高5例，类风湿因子（ RF）及抗核抗体（ ANA）升高各3例。8例被误诊而行手术治疗。经激素治疗后，患者预后良好。结论 AIP是一种少见的自身免疫性疾病，无特异临床表现，易与胰腺癌及胆管癌混淆，误诊率高。必须充分认识和重视AlP的诊治，避免因误诊而行不必要的手术治疗。
목적：분석병총결아원수치적자신면역성이선염（ AIP）림상특정급진치경험。방법회고성분석2009년지2013년아원수치적13례AIP적림상자료。결과13례AIP중，중위년령48세，림상표현주요위상복동통불괄，경조성황달급체중하강。이선미만성증대급국한성증대각6례，이체미가성낭종급이선결석각1례，이관확장4례。이선외기관수루9례（담관병변8례、담낭병변7례、복막후섬유화1례、복강림파결종대6례、비정맥변세4례、간조종합정급궤양성결장염각1례）。7례행혈면역표지물검사，IgG승고5례，류풍습인자（ RF）급항핵항체（ ANA）승고각3례。8례피오진이행수술치료。경격소치료후，환자예후량호。결론 AIP시일충소견적자신면역성질병，무특이림상표현，역여이선암급담관암혼효，오진솔고。필수충분인식화중시AlP적진치，피면인오진이행불필요적수술치료。
Objective To investigate and summarize the clinical characteristic of autoimmune pancreati-tis(AIP).Methods Clinical data of 13 patients with AIP, admitted to the West China Hospital from 2009 to 2013, were retrospectively analyzed .Results The median age of the 13 patients was 48 years old.The main clinical manifestations included epigastric pain or discomfort (8 cases), obstructive jaundice(7 cases)and weight loss(10 cases).Diffuse enlargement of pancreas and localized pancreatic enlargement were observed in 6 cases, pseudocyst and pancreatic stones were observed in 1 case.Dilation of pancreatic duct was found in 4 cases.Bili-ary stricture and thickened wall of bile duct were detected in 8 cases, dilated gallbladder with delayed enhance-ment of the thickened wall in 7 cases, retroperitoneal fibrosis surrounding the aorta in 1 case, abdominal lymph-adenopathy in 6 cases, stenosis of splenic vein in 4 cases, and Sjogren's disease and ulcerative colitis in 1 case. The positive rate of serum IgG, RF, ANA was 71.43%(5/7), 42.86%(3/7), and 42.86%(3/7), respec-tively.8 patients were misdiagnosed and underwent surgery .Steroid therapy was administered in all patients with satisfactory response.Conclusions AIP is a rare and autoimmune disease ,without speci? c symptoms,and often be misdiagnosed as pancreatic cancer or bile duct carcinoma .We must give more attention to AIP and keep pa-tients from undergoing unnecessary surgery .