1型自身免疫性胰腺炎的流行病学及临床特点

摘要

目的 总结自身免疫性胰腺炎(AIP)的流行病特征、临床表现和诊断经验,提高诊治水平.方法 回顾性分析了北京协和医院自1998年1月至2016年12月所有确诊为AIP的临床资料.结果 共纳入194例1型AIP.该病发病的男女比例为3.51/1,平均发病年龄为(57±15)岁.最常见的症状是黄疸和腹痛等.最常见的胰腺外受累疾病是硬化性胆管炎、涎腺炎和IgG4肾病.36.68%AIP患者合并糖尿病.IgG4、ANA、ESR、C反应蛋白和CA199均有助于疾病诊断和病情判断.病理、pet-CT和激素治疗反应均有助于AIP的诊断.结论 作为一种系统性疾病的胰腺表现,1型AIP有特殊的临床特点和实验室检查特点.AIP的诊断可应用多种检测手段和方法.%Objective To improve the diagnosis and treatment of type Ⅰ autoimmune pancreatitis, a study was carried out to summarize the epidemiological characteristics, clinical manifestations and diagnosis of autoimmune pancreatitis (AIP).Methods This study retrospectively analyzed the clinical data of all the patients diagnosed with AIP from January 1998 to December 2016 in the ward of Peking union medical college hospital.Results 194 type 1 AIP patients were enrolled in this study.The M/F ratio of the disease was 3.51/1,with an average age of 57±15 years.The most common symptom is jaundice, abdominal pain and weight loss.The most common diseases of the pancreas are sclerosing cholangitis, salivary glands, IgG4 nephropathy.There are 36.68 percent of AIP patients with diabetes mellitus.IgG4, ANA, ESR, c-reactive protein and CA199 are all contribute to disease diagnosis and follow-up.Pathology, pet-CT and hormone therapy response all contribute to the diagnosis of AIP.Conclusions As a systemic disease, the type 1 AIP has special clinical features and laboratory profiles.The diagnosis of AIP can be applied in many ways.