摘要
目的探讨自身免疫性胰腺炎(autoimmune pancreatitis,AIP)的临床特点,提高对AIP的认识,降低误诊率。方法回顾性分析中国人民解放军总医院2008年9月-2013年7月诊治的41例AIP患者的临床资料。结果 41例AIP患者主要临床表现为黄疸,伴有其他免疫疾病11例。41例患者胰腺均肿大,17例胰周见囊状环,内镜逆行性胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)检查5例显示胰管不规则狭窄。血清Ig G4升高19例。9例因误诊为胰腺癌或胆管癌行外科手术。按2012年我国AIP诊断标准草案重新诊断所有患者,2例依据A组确诊,6例依据B组诊断,29例依据C组诊断,其余4例除外。结论AIP是一种以自身免疫性炎症为特征的特殊类型的慢性胰腺炎,临床上易误诊为胰腺癌、胆管癌。2012年我国诊断标准适合我国临床实践。应充分重视影像学检查,尤其是ERCP检查对AIP诊断的重要性。
Objective To investigate the clinical characteristics of autoimmune pancreatitis （ALP）, improve the un- derstanding of AIP and reduce the misdiagnostic rate. Methods Clinical data about 41 AIP patients admitted in Chi- nese PLA General Hospital from Sep. 2008 to Jul. 2013 were retrospectively analyzed. Results The main clinical manifestation was intermittent jaundice. Eleven cases accompanied with other diseases of immune system. 41 AIP pa- tients＇ pancreas enlarged. 17 patients showed a ＂ capsule-like rim＂ surrouding the pancreas. Endoscopic retrograde cholangiopancreatography （ERCP） showed diffuse narrowing of the pancreatic duct with some irregularities in 5 patients. Nine patients were misdiagnosed as pancreatic or bile duct carcinoma and all of them were performed laparotomy. Ac- cording to the China diagnostic criteria, 2 cases were diagnosed according group A, 6 cases were diagnosed according group B, 29 cases were diagnosed according group C and other 4 cases were excluded. Conclusion AIP is character- ized by autoimmune inflammatory process,and it is easy to be misdiagnosed as pancreatic cancer or cholangiocareinoma etc. The 2012 China diagnostic criterian is suitable with Chinese population. We should pay more attention to the ima- ging examination, especially the ERCP of the diagnosis on AIP.
出处
《胃肠病学和肝病学杂志》
CAS
2016年第1期94-96,共3页
Chinese Journal of Gastroenterology and Hepatology
