Exocrine pancreatic ductograms in insulin-dependent diabetes mellitus.
Exocrine pancreatic ductograms in insulin-dependent diabetes mellitus.
复制标题
胰岛素依赖型糖尿病的外分泌胰腺导管图。
DOI：
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发表时间：
1994
影响因子：
9.8
通讯作者：
K. Kosáka
中科院分区：
文献类型：
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作者：
K. Nakanishi;T. Kobayashi;H. Miyashita;M. Okubo;T. Sugimoto;T. Murase;M. Hashimoto;S. Fukuchi;K. Kosáka
目标
目的了解胰岛素依赖型糖尿病(IDDM)患者胰管造影异常的发生率，并探讨其临床特点。
方法
对43例胰岛素依赖型糖尿病(IDDM)、12例胰岛细胞抗体(ICA)阳性的非胰岛素依赖型糖尿病(NIDDM)和22例ICA阴性的NIDDM患者的胰腺外分泌进行了内窥镜逆行胰腺造影术(ERP)观察。
结果
事件相关电位显示胰岛素依赖型糖尿病患者胰管异常(扩张、狭窄、弯曲、梗阻和胆管内结石)发生率(17/43，40%)显著高于ICA阴性患者(2/22，9%，P=0.018)。发病13个月后缓慢发展为胰岛素依赖的IDDM患者胰管异常发生率(13/22，59%)高于发病12个月内需要胰岛素治疗的患者(4/21，19%，P=0.016)。两组患者的糖尿病病程没有差异。ICA阳性患者胰管异常发生率(7/12，58%)明显高于ICA阴性患者(2/22，9%，P=0.0074)。
结论
这些结果表明，长期有ICA非胰岛素依赖史的IDDM患者有很高比例的胰腺外分泌受损。临床病程进展缓慢的IDDM与热带国家常见的纤维结石性胰腺糖尿病之间也有相似之处。
OBJECTIVES
To examine the prevalence of abnormal pancreatic ductograms in patients with insulin-dependent diabetes mellitus (IDDM) and to determine the clinical characteristics of those patients.
METHODS
Pancreatic exocrine morphology was studied by endoscopic retrograde pancreatography (ERP) in 43 patients with IDDM, 12 patients with islet cell antibody (ICA)-positive non-insulin-dependent diabetes mellitus (NIDDM), and 22 patients with ICA-negative NIDDM.
RESULTS
ERP revealed a significantly higher prevalence of abnormal pancreatic ducts (dilation and stenosis, tortuosity, obstruction, and intraductal calculi) in the patients with IDDM (17/43, 40%) than in the patients with ICA-negative NIDDM (2/22, 9%, p = 0.018). IDDM patients who slowly progressed to insulin dependency more than 13 months after the onset of diabetes had a higher frequency of abnormal pancreatic ducts (13/22, 59%) than those who needed insulin therapy within 12 months after the onset (4/21, 19%, p = 0.016). There was no difference in duration of diabetes between the two groups. ICA-positive NIDDM patients also had a higher frequency of abnormal pancreatic ducts (7/12, 58%) than ICA-negative NIDDM patients (2/22, 9%, p = 0.0074).
CONCLUSIONS
These results indicate that a high proportion of IDDM patients who have prolonged histories of non-insulin dependency with ICA suffer pancreatic exocrine impairment. A similarity between IDDM with a slowly progressive clinical course and fibrocalculous pancreatic diabetes seen in tropical countries also was suggested.