Factors associated with prior acute pancreatitis episodes among patients with chronic pancreatitis
Factors associated with prior acute pancreatitis episodes among patients with chronic pancreatitis
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慢性胰腺炎患者既往急性胰腺炎发作的相关因素
DOI：
10.1016/j.dld.2021.03.001
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发表时间：
2021-08-25
影响因子：
4.5
通讯作者：
Liao, Zhuan
中科院分区：
文献类型：
--
作者：
Ru, Nan;Zhu, Jia-Hui;Liao, Zhuan
背景：慢性胰腺炎（CP）和急性胰腺炎（AP）之间的关系是复杂的，并没有得到很好的理解。CP之前可能有AP的先行发作。目的：本研究的目的是探讨与CP诊断前AP发作相关的遗传和环境因素。方法：这是一项横断面研究，包括1022例患者。收集了详细的人口统计学、遗传学和临床数据。根据CP诊断前是否有AP发作，将患者分为AP组（进一步分为AP单次发作组和AP复发组）和非AP组。采用多因素Logistic回归模型分析各组间的相关因素。结果：737例（72.1%）患者在确诊CP前有AP病史。吸烟（P= 0.005）和大量饮酒（P= 0.002）是AP的危险因素，而CP发病年龄（P < 0.001）、SPINK1突变（P < 0.001）、糖尿病（P < 0.001）和肥胖（P < 0.001）是保护因素。酒精性CP（P= 0.019）是AP复发的唯一独立危险因素，而发病年龄（P < 0.001）、胰腺结石（P= 0.024）是AP复发的唯一独立危险因素。假性囊肿（P= 0.018）为保护因素。结论：SPINK1基因突变是AP发病的保护性因素，提示SPINK1基因突变可能在临床表现隐匿的CP发病中起致病作用。(c)2021 Editrice Gastroenterology Italiana S.r.l.由爱思唯尔有限公司出版。保留所有权利。
Background: The relationship between chronic pancreatitis (CP) and acute pancreatitis (AP) is complex and not well understood. CP could be preceded by antecedent episodes of AP. Aims: The aim of this study was to explore both genetic and environmental factors associated with AP episodes before the diagnosis of CP. Methods: This was a cross-sectional study including 1022 patients. Detailed demographic, genetic, and clinical data were collected. Based on the presence of AP episode(s) before diagnosis of CP, patients were divided into AP group (further classified into single episode of AP group and recurrent AP group) and non-AP group. Related factors among these groups were assessed using multivariate logistic regression model. Results: Before diagnosis of CP, 737 patients (72.1%) had a history of AP. Smoking(P= 0.005) and heavy alcohol consumption(P= 0.002) were risk factors for AP while age at CP onset(P < 0.001), harboring the SPINK1 mutation(P < 0.001), diabetes(P < 0.001) and steatorrhea(P < 0.001) were protective factors. Fur-ther, alcoholic CP(P= 0.019) was the only independent risk factor for recurrent AP attacks while age at onset of CP(P < 0.001), pancreatic stones(P= 0.024). and pseudocysts(P= 0.018) served as protective fac-tors. Conclusions: SPINK1 mutations served as protective factor for AP episodes, suggesting SPINK1 mutation might play a pathogenic role in CP occurrence with occult clinical manifestations. (c) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.