淮海医药
淮海醫藥
회해의약
Journal of Huaihai Medicine
2015年
6期
529-530,531
,共3页
自身免疫性胰腺炎%临床特点%实验室指标%自身抗体
自身免疫性胰腺炎%臨床特點%實驗室指標%自身抗體
자신면역성이선염%림상특점%실험실지표%자신항체
Autoimmune pancreatitis%Clinical characteristics%Laboratory index%Autoantibody
目的：探讨自身免疫性胰腺炎（ AIP）临床特点及实验室指标。方法回顾性分析和41例AIP患者的临床症状、生化指标、自身抗体特征。结果本组41例AIP患者中32例为男性，男女比例为3．6：1，最常见的临床表现为上腹痛51．22％、黄疸46．34％、厌食加消廋26．83％；最常见的合并症分别为慢性胆囊炎34．15％、糖尿病17．07％、自身免疫性疾病26．09％（6／23）。血清学最常见的变化：γ－谷氨酸转肽酶（γ-GT）75．61％、天冬氨酸转氨酶（AST）70.73％、胆红素（TB）65．85％均升高，另外血清CA19-963．64％升高、血淀粉酶（AMY）58．54％一过性升高；免疫球蛋白IgG 47．83％升高。结论 AIP患者多为中年以上男性，临床常以腹痛和黄疸而就诊，并常并发胆囊炎、糖尿病及自身免疫病等，以血清酶类、TB、CA19-9、IgG水平升高为特点，血清自身抗体阳性表达；极易被误诊为胰腺癌而接受不必要的手术，也常被误诊为慢性胰腺炎（ CP）而失去有效治疗的机会，临床应加强对AIP的认识。
目的：探討自身免疫性胰腺炎（ AIP）臨床特點及實驗室指標。方法迴顧性分析和41例AIP患者的臨床癥狀、生化指標、自身抗體特徵。結果本組41例AIP患者中32例為男性，男女比例為3．6：1，最常見的臨床錶現為上腹痛51．22％、黃疸46．34％、厭食加消廋26．83％；最常見的閤併癥分彆為慢性膽囊炎34．15％、糖尿病17．07％、自身免疫性疾病26．09％（6／23）。血清學最常見的變化：γ－穀氨痠轉肽酶（γ-GT）75．61％、天鼕氨痠轉氨酶（AST）70.73％、膽紅素（TB）65．85％均升高，另外血清CA19-963．64％升高、血澱粉酶（AMY）58．54％一過性升高；免疫毬蛋白IgG 47．83％升高。結論 AIP患者多為中年以上男性，臨床常以腹痛和黃疸而就診，併常併髮膽囊炎、糖尿病及自身免疫病等，以血清酶類、TB、CA19-9、IgG水平升高為特點，血清自身抗體暘性錶達；極易被誤診為胰腺癌而接受不必要的手術，也常被誤診為慢性胰腺炎（ CP）而失去有效治療的機會，臨床應加彊對AIP的認識。
목적：탐토자신면역성이선염（ AIP）림상특점급실험실지표。방법회고성분석화41례AIP환자적림상증상、생화지표、자신항체특정。결과본조41례AIP환자중32례위남성，남녀비례위3．6：1，최상견적림상표현위상복통51．22％、황달46．34％、염식가소수26．83％；최상견적합병증분별위만성담낭염34．15％、당뇨병17．07％、자신면역성질병26．09％（6／23）。혈청학최상견적변화：γ－곡안산전태매（γ-GT）75．61％、천동안산전안매（AST）70.73％、담홍소（TB）65．85％균승고，령외혈청CA19-963．64％승고、혈정분매（AMY）58．54％일과성승고；면역구단백IgG 47．83％승고。결론 AIP환자다위중년이상남성，림상상이복통화황달이취진，병상병발담낭염、당뇨병급자신면역병등，이혈청매류、TB、CA19-9、IgG수평승고위특점，혈청자신항체양성표체；겁역피오진위이선암이접수불필요적수술，야상피오진위만성이선염（ CP）이실거유효치료적궤회，림상응가강대AIP적인식。
Objective To discuss the clinical characteristics and laboratory indexes of the patients with autoimmune pan-creatitis ( AIP) .Methods A total of 41 patients with AIP were enrolled in the study.The clinical symptoms and biochemical indexes were analyzed,and the characteristics of autoantibodies were investigated.Results Of the 41 patients with AIP,32 were males and the sex ratio were 3.6 :1.The major clinical manifestations were epigastric pain (51.22%),jaundice (46.34%),anorexia and hide(26.83%).The common complications were chronic cholecystitis(34.15%),diabetes mellitus (17.07)and autoimmune disease(26.09%).The common serological changes were:γ-GT (75.61%),AST (70.73%)and bilirubin(65.85%),which all went up.In addition,CA19-9 (63.64%),IgG (47.83%)also rose and blood amylase(AMY) was observed as 58.54%higher.Conclusion AIP mainly occurs in elderly male patients with chronic cholecystitis,diabetes and autoimmune disease.The major clinical manifestations of the patients are abdominal pain and jaundice.The characteristics of serology are the rising of serum enzymes,bilirubin,CA19-9 and Ig-G and serum antibody positive expression.The patients of AIP are easy to be misdiagnosed as pancreatic cancer and receive unnecessary surgery or to be misdiagnosed as chronic pancre-atitis( CP) and lose effective treatment.So clinician should strengthen the awareness of AIP.
