Retrospective study of steroid therapy for patients with autoimmune pancreatitis in a Chinese population
Retrospective study of steroid therapy for patients with autoimmune pancreatitis in a Chinese population
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中国人群自身免疫性胰腺炎患者类固醇治疗的回顾性研究。
DOI：
10.3748/wjg.v19.i4.569
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发表时间：
2013-01-28
影响因子：
4.3
通讯作者：
Zhang, Zhi-Xiang
中科院分区：
文献类型：
--
作者：
Liu, Bin;Li, Jing;Zhang, Zhi-Xiang
目的：探讨激素治疗自身免疫性胰腺炎的最佳治疗策略。方法：本研究在中国的两家大型机构进行。纳入临床、放射学和生化诊断为AIP的患者。结果：28例AIP患者接受了激素治疗，40例患者接受了手术治疗，包括胰十二指肠切除、胰尾切除、胆总管空肠吻合术、扩大胰头射频消融术、经皮肝穿胆管引流术和内窥镜胆管引流术。起始剂量为30 mg/d者18例(64.3%)，40 mg/d者10例(35.7%)，疗程3wk。激素治疗的AIP患者缓解率(96.4%)明显高于非激素治疗的缓解率(75%)。缓解后给予维持治疗(口服强的松龙5 mg/d)，至少6~12mo，完成整个疗程。类似地，接受激素治疗的AIP患者的复发率(28.6%)显著低于未接受激素治疗的患者(42.5%)。结论：所有AIP活动期炎症期患者均应考虑激素治疗。然而，最优方案仍然应该在更多的AIP患者中进行跟踪。(C)2013年白石登。版权所有。
AIM: To explore the optimal steroid therapeutic strategy for autoimmune pancreatitis (AIP).METHODS: This study was conducted retrospectively in two large institutions in China. Patients with clinically, radiologically and biochemically diagnosed AIP were enrolled. The performed radiological investigations and biochemical tests, the regimen of the given steroid treatment, remission and relapse whether with and without steroid therapy were analyzed.RESULTS: Twenty-eight patients with AIP received steroid treatment, while 40 patients were treated surgically by pancreatoduodenectomy, distal pancreatectomy and choledochojejunostomy, radiofrequency ablation for the enlarged pancreatic head, percutaneous transhepatic biliary drainage and endoscopic biliary drainage. The starting oral prednisolone dose was 30 mg/d in 18 (64.3%) patients and 40 mg/d in 10 (35.7%) patients administered for 3 wk. The remission rate of AIP patients with steroid treatment (96.4%) was significantly higher than in those without steroid treatment (75%). Maintenance therapy (oral prednisolone dose 5 mg/d) was performed after remission for at least 6-12 mo to complete the treatment course. Similarly, the relapse rate was significantly lower in AIP patients with steroid treatment (28.6%) than in those without steroid treatment (42.5%). Steroid re-treatment was effective in all relapsed patients with or without steroid therapy.CONCLUSION: Steroid therapy should be considered in all patients with active inflammatory phase of AIP. However, the optimal regimen still should be trailed in larger numbers of patients with AIP. (C) 2013 Baishideng. All rights reserved.