自身免疫性胰腺炎与胰腺癌的超声特点及临床表现比较

详细信息    查看全文 | 推荐本文 |

英文篇名：Comparison of ultrasonography characteristics and clinical manifestations between autoimmune pancreatitis and pancreatic cancer 作者：韩玉彩 英文作者：HAN Yu-cai;Traditional Chinese Medicine Hospital of Luochuan County; 关键词：自身免疫性胰腺炎 ; 胰腺癌 ; 超声 英文关键词：autoimmune pancreatitis;;pancreatic cancer;;ultrasonography 中文刊名：YLYS 英文刊名：Clinical Research and Practice 机构：洛川县中医医院; 出版日期：2019-03-11 出版单位：临床医学研究与实践 年：2019 期：v.4 语种：中文; 页：YLYS201908038 页数：2 CN：08 ISSN：61-1503/R 分类号：104-105

摘要

目的研究自身免疫性胰腺炎(AIP)和胰腺癌的超声特点及临床表现。方法回顾性分析30例AIP患者(观察组)和30例胰腺癌患者(对照组)的临床资料,比较AIP和胰腺癌患者的超声特点和临床表现。结果两组患者的肿瘤病灶直径、腹胀、体重下降及糖尿病史发生率比较,差异均无统计学意义(P>0.05);两组患者的病变范围、腹痛评分及黄疸发生率比较,差异均具有统计学意义(P<0.05)。观察组胰腺体尾部萎缩、胰管阻塞性扩张、血管受累发生率显著低于对照组,胆总管厚壁性狭窄和胆管壁增厚发生率显著高于对照组(P<0.05)。结论 AIP患者病变以弥漫性为主,腹部疼痛和黄疸症状及超声检查均有助于鉴别诊断。
        Objective To study the ultrasonographic and clinical manifestations of autoimmune pancreatitis(AIP) and pancreatic cancer. Methods The clinicopathological data of 30 AIP patients(observation group) and 30 pancreatic cancer patients(control group) were retrospectively analyzed. The ultrasonography characteristics and clinical manifestations of patients with AIP and pancreatic cancer were compared. Results There were no significant differences in tumor diameter,incidences of abdominal distention, weight loss and diabetes history between the two groups(P >0.05). There were significant differences in the range of lesions, abdominal pain scores and incidences of jaundice between the two groups(P<0.05). The incidences of pancreatic atrophy, obstructive dilatation of pancreatic bile duct and vascular involvement in the observation group were significantly lower than those in the control group, the incidences of choledochal thickening stenosis and bile duct wall thickening were significantly higher than those of the control group(P<0.05). Conclusion The lesions of AIP patients are mainly diffuse, the abdominal pain, jaundice symptoms and ultrasonography are helpful for differential diagnosis.

引文

[1]赖雅敏,吴东,杨红,等.1型自身免疫性胰腺炎的流行病学及临床特点[J].基础医学与临床,2017,37(11):1607-1610.
    [2]RASCH S,PHILLIP V,SCHMID RM,et al.Epidemiology,clinical presentation,diagnosis and treatment of autoimmune pancreatitis:a retrospective analysis of 53 patients[J].Pancreatology,2016,16(1):73-77.
    [3]KIM HJ,KIM YK,JEONG WK,et al.Pancreatic duct"Icicle sign"on MRI for distinguishing autoimmune pancreatitis from pancreatic ductal adenocarcinoma in the proximal pancreas[J].Eur Radiol,2015,25(6):1551-1560.
    [4]OTSUKI M,CHUNG JB,OKAZAKI K,et al.Asian diagnostic criteria for autoimmune pancreatitis:consensus of the Japan-Korea symposium on autoimmune pancreatitis[J].J Gastroenterol,2008,43(6):403-408.
    [5]王荣欣,秦俭,胡水清,等.自身免疫性胰腺炎的胰腺外表现[J].现代生物医学进展,2015,15(17):3360-3362.
    [6]苏里亚,高瑛,徐光,等.超声检查对自身免疫性胰腺炎的诊断价值[J].中华医学杂志,2012,92(37):2649-2651.
    [7]MADHANI K,FARRELL JJ.Autoimmune pancreatitis:an update on diagnosis and management[J].Gastroenterol Clin North Am,2016,45(1):29-43.
    [8]张新刚,温锋,董幼丹,等.自身免疫性胰腺炎与胰腺癌在影像学方面的鉴别诊断研究[J].中国医师进修杂志,2013,36(15):4-8.
    [9]张阿萌,康眼训.螺旋CT在胰腺癌、胰腺内分泌肿瘤及自身免疫性胰腺炎鉴别诊断中的应用[J].现代消化及介入诊疗,2016,21(5):686-688,694.
    [10]梁雨荣,顾万清.IgG4相关性自身免疫性胰腺炎的临床特点[J].中华保健医学杂志,2013,15(5):439-441.
    [11]孟德莉,邢玲玲,刘祖平.超声在自身免疫性胰腺炎与胰腺癌鉴别诊断中的价值[J].中华胰腺病杂志,2015,15(1):53-54.
    [12]霍忠超,苏英,王丽,等.卡陪他滨联合精确放疗同步治疗晚期胰腺癌的临床观察[J].结直肠肛门外科,2016,22(S1):150-151.