Chronic pancreatitis
Chronic pancreatitis
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DOI：
10.1016/s0140-6736(97)07332-7
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发表时间：
1997-11-08
期刊：
影响因子：
168.9
通讯作者：
Baillie, J
中科院分区：
文献类型：
--
作者：
Mergener, L;Baillie, J
THE LANCET sensitivity to alcohol makes it difficult to pronounce even small amounts of alcohol “safe”. Some cases of so-called idiopathic pancreatitis may, in fact, be alcoholic pancreatitis in sensitive patients—other cases are undoubtedly due to surreptitious use of alcohol in toxic doses. However, only 5–10% of heavy drinkers develop pancreatitis. 5 The role of genetic or nutritional factors in the development of alcoholic pancreatitis is not known. Durbec and colleagues6 suggest that a diet high in protein and fat may predispose to chronic pancreatitis, although other investigators have failed to confirm this. 7 Dietary deficiency of trace elements such as selenium and zinc may predispose to pancreatic injury by decreased production of antioxidant enzymes. 8The mechanism by which ethanol causes chronic pancreatitis remains unknown and controversial. Sarles and colleagues9 suggest that ethanol causes the secretion of insoluble pancreatic proteins that then form calcified protein plugs within the pancreatic ductal system. Blocked acinar ducts may trigger intracellular activation of pancreatic enzymes or other pathological mechanisms and structurally damage the gland. Another theory suggests that inappropriate activation of the cytochrome p450 system increases oxidative stress and pancreatic-cell damage. 10 The lack of a suitable animal model has hampered research into the pathogenesis of chronic pancreatitis.
