The Long-Term Impact of Autoimmune Pancreatitis on Pancreatic Function, Quality of Life, and Life Expectancy
The Long-Term Impact of Autoimmune Pancreatitis on Pancreatic Function, Quality of Life, and Life Expectancy
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DOI：
10.1097/mpa.0000000000000451
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发表时间：
2015-10-01
期刊：
影响因子：
2.9
通讯作者：
Bruno, Marco J.
中科院分区：
文献类型：
--
作者：
Buijs, Jorie;Cahen, Djuna L.;Bruno, Marco J.
目的探讨自身免疫性胰腺炎的远期疗效。收集有关疾病特征、治疗结果、诊断的恶性肿瘤和死亡率的信息。此外，胰腺功能和生活质量进行了前瞻性assessedprospectively.Results 107例患者（87%的男性，90%的1型），中位随访时间为74（四分位距，49-108）个月。三分之一的人因怀疑胰腺癌而手术（32%）。大多数患者（成功地）用类固醇治疗（83%），但复发是常见的（52%），没有风险因素可以确定。未观察到胰腺癌。从64%的患者中获得了前瞻性数据，其中17%死亡，7%失访，13%拒绝参与。在中位数75个月（四分位距，50-106）后，46%的患者仍使用活性药物治疗。外分泌和内分泌不适应症的患病率很高（分别为82%和57%）。生活质量和生存率没有受损，与参考population.Conclusions尽管一个很好的初始治疗反应，复发是常见的，即使在2型，几乎一半的患者需要维持治疗。胰腺功能不全非常普遍，需要积极筛查。未观察到胰腺癌，生活质量和生存期未受损。
Objective To evaluate the long-term outcome of autoimmune pancreatitis.Methods Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosed malignancies, and mortality. In addition, pancreatic function and quality of life were assessed prospectively.Results 107 patients were included (87% men, 90% with type 1), with a median follow-up of 74 (interquartile range, 49-108) months. One third was operated for suspected pancreatic cancer (32%). Most patients were (successfully) treated with steroids (83%), but relapses were common (52%), for which no risk factors could be identified. Pancreatic carcinoma was not observed. Prospective data were obtained from 64%, as 17% had died, 7% were lost to follow-up, and 13% refused to participate. After a median of 75 (interquartile range, 50-106) months, 46% still used active treatment. Exocrine and endocrine insufficiencies were highly prevalent (82% and 57%, respectively). Quality of life and survival were not impaired, as compared with a reference population.Conclusions Despite an excellent initial treatment response, relapses are common, even in type 2, and almost half of the patients require maintenance therapy. Pancreatic insufficiency is highly prevalent, which calls for active screening. Pancreatic cancer was not observed, and quality of life and survival are not impaired.