Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus.
Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus.
复制标题
DOI：
10.1371/journal.pone.0188549
复制
发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Kaneko S
中科院分区：
文献类型：
--
作者：
Miyazawa M;Takatori H;Shimakami T;Kawaguchi K;Kitamura K;Arai K;Matsuda K;Sanada T;Urabe T;Inamura K;Kagaya T;Mizuno H;Fuchizaki U;Yamashita T;Sakai Y;Yamashita T;Mizukoshi E;Honda M;Kaneko S
复发和糖尿病（DM）是自身免疫性胰腺炎（AIP）预后的主要问题。我们检查了皮质类固醇治疗 (CST) 诱导缓解后 1 型 AIP 复发和 DM 的预后。该研究纳入了 82 名被诊断患有 1 型 AIP 的患者，他们通过 CST 获得了缓解。我们从 CST 的给药时间、与复发相关的临床因素以及糖耐量的时间变化方面回顾性评估了复发率。随访期间，32名患者（39.0%）出现复发。在开始 CST 之前，没有显着的临床因素可以预测复发。在 2 或 3 年内停止 CST 的 AIP 患者比继续 CST 的患者明显更早复发（p = 0.050 或 p = 0.020）。在 37 名糖尿病患者中，15 名患者（40.5%）既往患有糖尿病，17 名患者（45.9%）出现新发糖尿病，5 名患者（13.5%）出现 CST 诱发的糖尿病。新发糖尿病患者比已有糖尿病患者更有可能出现改善 (p = 0.008)。在开始 CST 之前，很难根据临床参数预测 AIP 的复发。开始 CST 后 3 年内可能会发生复发，维持 CST 至少 3 年可降低复发风险。对于糖耐量受损的 AIP，早期开始 CST 是可取的，因为先前存在的 DM 对 CST 是无效的。
Relapse and diabetes mellitus (DM) are major problems for the prognosis of autoimmune pancreatitis (AIP). We examined the prognosis of type 1 AIP after corticosteroid therapy (CST)-induced remission in terms of relapse and DM. The study enrolled 82 patients diagnosed with type 1 AIP who achieved remission with CST. We retrospectively evaluated the relapse rate in terms of the administration period of CST, clinical factors associated with relapse, and the temporal change in glucose tolerance. During follow-up, 32 patients (39.0%) experienced relapse. There was no significant clinical factor that could predict relapse before beginning CST. AIP patients who ceased CST within 2 or 3 years experienced significantly earlier relapse than those who had the continuance of CST (p = 0.050 or p = 0.020). Of the 37 DM patients, 15 patients (40.5%) had pre-existing DM, 17 (45.9%) showed new-onset DM, and 5 (13.5%) developed CST-induced DM. Patients with new-onset DM were significantly more likely to show improvement (p = 0.008) than those with pre-existing DM. It was difficult to predict relapse of AIP based on clinical parameters before beginning CST. Relapse was likely to occur within 3 years after the beginning of CST and maintenance of CST for at least 3 years reduced the risk of relapse. The early initiation of CST for AIP with impaired glucose tolerance is desirable because pre-existing DM is refractory to CST.
登录
查看更多内容
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。
影响因子：
4.3
作者：
Liu, Bin;Li, Jing;Zhang, Zhi-Xiang
通讯作者：
Zhang, Zhi-Xiang
DOI：
10.1038/ajg.2014.223
发表时间：
2014-10
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Huggett MT;Culver EL;Kumar M;Hurst JM;Rodriguez-Justo M;Chapman MH;Johnson GJ;Pereira SP;Chapman RW;Webster GJM;Barnes E
通讯作者：
Barnes E
影响因子：
158.5
作者：
Hamano, H;Kawa, S;Kiyosawa, K
通讯作者：
Kiyosawa, K
影响因子：
9.8
作者：
Maire, Frederique;Le Baleur, Yann;Hammel, Pascal
通讯作者：
Hammel, Pascal
影响因子：
3.6
作者：
Frulloni, Luca;Scattolini, Chiara;Vantini, Italo
通讯作者：
Vantini, Italo