J Clin Gastro:胰腺外分泌功能不全会导致慢性胰腺炎患者死亡风险增加

2018-09-02 MedSci MedSci原创

胰腺外分泌功能不全(PEI)是慢性胰腺炎(CP)最常见的并发症;然而,此严重的并发症对这些患者对死亡率的影响目前我们还知之甚少,本项研究就此评估了PEI对于CP患者的死亡风险。

背景:
胰腺外分泌功能不全(PEI)是慢性胰腺炎(CP)最常见的并发症;然而,此严重的并发症对这些患者对死亡率的影响目前我们还知之甚少,本项研究就此评估了PEI对于CP患者的死亡风险。

方法:
本项研究为前瞻性纵向队列研究,研究人员对CP患者进行长期随访。CP和PEI分别使用胰腺成像和13?C标记的混合甘油三酯呼气试验进行诊断。研究结果则采用多变量分析以评估PEI和其他因素对死亡风险的影响。

结果:
本项研究平均随访时间为8.6±4.6年,共有430名患者入选,男性79.1%;平均年龄47.8岁。PEI患病率为29.3%,死亡率为10.9%。最常见的死亡原因是癌症(40.4%),其次是感染(21.3%)和急性血管事件(14.9%)。多变量分析显示死亡率增加与PEI存在之间存在明显关联[(HR):2.59;95%(CI),1.42-4.71;P<0.003],肝硬化(HR,3.87; 95%CI,1.95-7.69;P<0.001),诊断年龄(HR,1.05; 95%CI,1.03-1.09;P<0.001),CP的毒性病因(HR,3.11; 95%CI,1.11-8.70;P<0.05)和呼吸道合并症(HR,2.19; 95%CI,1.12-4.31;P<0.03)。

结论:PEI是CP患者死亡率的重要独立危险因素。本项研究的结果鼓励研究人员对PEI进行进一步研究,以降低该人群的死亡率。

原始出处:
de la Iglesia-Garcia, Daniel. Et al. Increased Risk of Mortality Associated With Pancreatic Exocrine Insufficiency in Patients With Chronic Pancreatitis.Journal of Clinical Gastroenterology. 2018.

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    2019-02-20 许安
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    2019-06-26 gwc392
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