Risk Factors for Steatorrhea in Chronic Pancreatitis: A Cohort of 2,153 Patients.
Risk Factors for Steatorrhea in Chronic Pancreatitis: A Cohort of 2,153 Patients.
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慢性胰腺炎脂肪泻的危险因素：2,153 名患者的队列。
DOI：
10.1038/srep21381
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发表时间：
2016-02-15
影响因子：
4.6
通讯作者：
Li ZS
中科院分区：
文献类型：
--
作者：
Li BR;Pan J;Du TT;Liao Z;Ye B;Zou WB;Chen H;Ji JT;Zheng ZH;Wang D;Lin JH;Ning SB;Hu LH;Li ZS
本研究旨在探讨慢性胰腺炎（CP）中脂肪肝的发生率及其危险因素。这是基于对2000年1月至2013年12月期间在我中心住院的CP患者的回顾性和前瞻性数据库的分析。详细记录患者的人口统计学数据、病程、病史和随访评估。使用Kaplan-Meier方法计算脂肪累积率。对于危险因素分析，采用考克斯比例风险回归模型进行多变量分析。共纳入2，153例CP患者，平均随访时间为9.3年。大约14%（291/2，153）的CP患者在诊断CP时出现脂肪酸中毒。在确诊CP后1、5、10和20年的累积脂肪肝发生率为4.27%（95% CI：3.42%~ 5.34%）、12.53%（95% CI：10.74%~ 14.59%）、20.44%（95% CI：17.37%~ 23.98%）和30.82%（95% CI：20.20%~ 45.21%）。男性性别（HR = 1.771，p = 0.004），糖尿病（HR = 1.923，p < 0.001），酗酒（HR = 1.503，p = 0.025）和胰十二指肠切除术（HR = 2.901，p < 0.001）是脂肪代谢的独立危险因素，而青少年CP（HR = 0.433，p = 0.009）是保护因素。总之，男性、成年人、糖尿病、酗酒和胰腺炎切除术导致CP患者脂肪代谢风险增加。
This study aimed to investigate the occurrence of and determine the risk factors for steatorrhea in chronic pancreatitis (CP). It was based on analysis of both retrospectively and prospectively acquired database for CP patients admitted to our center from January 2000 to December 2013. Demographic data, course of disease, medical history, and follow-up evaluations of patients were documented in detail. Cumulative rate of steatorrhea was calculated by using the Kaplan–Meier method. For risk factor analysis, multivariate analysis by Cox proportional hazards regression model was performed. A total of 2,153 CP patients were included with a mean follow-up duration of 9.3 years. Approximately 14% (291/2,153) of CP patients presented with steatorrhea at diagnosis of CP. Cumulative rates of steatorrhea at 1, 5, 10, and 20 years after diagnosis of CP were 4.27% (95% CI: 3.42%–5.34%), 12.53% (95% CI: 10.74%–14.59%), 20.44% (95% CI: 17.37%–23.98%) and 30.82% (95% CI: 20.20%–45.21%), respectively. Male gender (HR = 1.771, p = 0.004), diabetes (HR = 1.923, p < 0.001), alcohol abuse (HR = 1.503, p = 0.025) and pancreaticoduodenectomy (HR = 2.901, p < 0.001) were independent risk factors for steatorrhea while CP in adolescents (HR = 0.433, p = 0.009) was a protective factor. In conclusion, male gender, adult, diabetes, alcohol abuse and pancreaticoduodenectomy lead to increased risk of steatorrhea in CP patients.