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Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease 被引量:26
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作者 Roberto Catanzaro Biagio Cuffari +1 位作者 Angelo Italia Francesco Marotta 《World Journal of Gastroenterology》 SCIE CAS 2016年第34期7660-7675,共16页
After the first description of fatty pancreas in 1933,the effects of pancreatic steatosis have been poorly investigated,compared with that of the liver. However,the interest of research is increasing. Fat accumulation... After the first description of fatty pancreas in 1933,the effects of pancreatic steatosis have been poorly investigated,compared with that of the liver. However,the interest of research is increasing. Fat accumulation,associated with obesity and the metabolic syndrome(Met S),has been defined as "fatty infiltration" or "nonalcoholic fatty pancreas disease"(NAFPD). The term "fatty replacement" describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity,increasing age,male sex,hypertension,dyslipidemia,alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus,Met S,atherosclerosis,severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of "ectopic fat deposition",which is a key element of nonalcoholic fatty liver disease and/or Met S. Moreover,in patients with fatty pancreas,pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula. 展开更多
关键词 Metabolic syndrome NONALCOHOLIC FATTY liver DISEASE pancreatic steatosis pancreatic LIPOMATOSIS NONALCOHOLIC FATTY PANCREAS DISEASE FATTY PANCREAS pancreatic fat pancreatic FATTY replacement pancreatic FATTY infiltration pancreatic cancer
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Pancreatic steatosis: Is it related to either obesity or diabetes mellitus? 被引量:11
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作者 Raffaele Pezzilli Lucia Calculli 《World Journal of Diabetes》 SCIE CAS 2014年第4期415-419,共5页
The accumulation of fat in the pancreatic gland has been referred to using various synonyms,such as pancreatic lipomatosis,fatty replacement,fatty infiltration,fatty pancreas,lipomatous pseudohypertrophy,non-alcoholic... The accumulation of fat in the pancreatic gland has been referred to using various synonyms,such as pancreatic lipomatosis,fatty replacement,fatty infiltration,fatty pancreas,lipomatous pseudohypertrophy,non-alcoholic fatty pancreatic disease and pancreatic steatosis We believe that pancreatic steatosis is the best description of fat accumulation in the pancreatic gland without fat replacement,and this term also describes the possibility that the fat accumulation is a reversible process.A review of the existing literature was carried out,and it was found that there was notable evidence from both the pathological and the imaging point of view that pancreatic steatosis is an increasing problem due to the increasing incidence of obesity.The conclusion was that pancreatic steatosis was easily detectable using modern imaging techniques,such as ultrasonography,endoscopic ultrasonography,computed tomography and magnetic resonance imaging.Pancreatic steatosis was not due to the presence of diabetes mellitus but was highly associated with the metabolic syndrome.The possible presence of steatopancreatitis should be better evaluated,especially regarding the inflammatory cascade,and additional studies are needed which are capable of assessing whether non-alcoholic steatopancreatitis really exists as does non-alcoholic steatohepatitis.Finally,the presence of exocrine pancreatic function should be extensively evaluated in patients with pancreatic steatosis. 展开更多
关键词 COMPUTED tomography Endoscopic ULTRASONOGRAPHY Magnetic resonance imaging Metabolic syndrome pancreatic steatosis Pathology Type 2 diabetes MELLITUS ULTRASONOGRAPHY
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脂肪胰与胰腺癌:从肿瘤发生到外科治疗 被引量:3
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作者 展翰翔 《中华消化外科杂志》 CAS CSCD 北大核心 2022年第4期470-474,共5页
肥胖症、饮酒及代谢性疾病等可引起脂肪细胞在胰腺组织中堆积和浸润, 导致脂肪胰的发生。脂肪胰临床关注较少, 尚未引起广大临床医师重视, 但前期研究结果证实其与胰腺癌发生、发展、手术并发症及预后密切相关。脂肪胰环境下脂肪细胞和... 肥胖症、饮酒及代谢性疾病等可引起脂肪细胞在胰腺组织中堆积和浸润, 导致脂肪胰的发生。脂肪胰临床关注较少, 尚未引起广大临床医师重视, 但前期研究结果证实其与胰腺癌发生、发展、手术并发症及预后密切相关。脂肪胰环境下脂肪细胞和巨噬细胞等炎症细胞在腺泡组织中聚集, 加重胰腺组织局部炎症状态, 刺激胰腺导管上皮不典型增生, 促进胰腺癌发生。脂肪胰患者发生胰腺癌的概率明显增高, 且更易出现淋巴结转移, 预后更差。脂肪胰状态下胰腺质地变软、变脆, 胰腺切除术后发生胰瘘及相关并发症风险明显增高。关于脂肪胰的诊断, 影像学检查方面, 常采用腹部平扫CT或磁共振成像检查;组织学检查方面, 胰腺腺泡组织中见大量脂肪细胞浸润可明确诊断脂肪胰。外科医师应提高对脂肪胰的重视程度, 熟悉其诊断标准及临床意义, 并对其进行积极预防和早期干预, 减少胰腺癌的发生。对于胰腺癌合并脂肪胰的患者, 围手术期应积极控制血糖、血压等代谢性疾病, 术中注重手术细节, 保证胰肠吻合质量, 减少术后并发症发生。笔者综合分析国内外相关研究进展并结合自身经验, 深入分析脂肪胰在胰腺癌发生、发展中的作用及对临床诊断与治疗的重要影响, 探讨合并脂肪胰的胰腺癌患者围手术期处理策略。 展开更多
关键词 胰腺肿瘤 脂肪胰 肥胖症 胰瘘 肿瘤微环境
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胰腺脂肪浸润的研究进展 被引量:3
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作者 刘玉清 邸阜生 《国际内分泌代谢杂志》 北大核心 2013年第2期118-121,共4页
胰腺的甘油三酯沉积过多,或胰腺组织发生脂肪替代时,会形成“胰腺脂肪浸润”。根据其脂质沉积于细胞内外的不同,发生机制也不相同。虽然组织学检查为诊断胰腺脂肪浸润的金标准,但临床上常应用影像学技术进行确诊,且核磁共振技术与... 胰腺的甘油三酯沉积过多,或胰腺组织发生脂肪替代时,会形成“胰腺脂肪浸润”。根据其脂质沉积于细胞内外的不同,发生机制也不相同。虽然组织学检查为诊断胰腺脂肪浸润的金标准,但临床上常应用影像学技术进行确诊,且核磁共振技术与生化测量具有高度一致性。由于胰腺脂肪浸润可影响胰腺本身及其他疾病的发生、发展,因此对其早期诊断和干预可为治疗相关疾病提供新思路。 展开更多
关键词 胰腺脂肪浸润 胰腺脂肪变性 胰脏脂肪沉积 诊断
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化学位移MRI测量2型糖尿病患者胰腺脂肪含量的临床研究 被引量:2
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作者 柴军 刘朋 +6 位作者 洪旭 尹洁 于恒池 苏天昊 张洁 史凯宁 靳二虎 《临床和实验医学杂志》 2015年第1期20-23,共4页
目的采用化学位移MRI研究初诊2型糖尿病患者的胰腺脂肪含量及分布特点,并探讨胰腺与肝脏脂肪含量的相关性。方法征集初诊的2型糖尿病患者70例,采用化学位移双回波MRI技术分别测量胰腺头部、体部、尾部及肝脏的脂肪含量,比较胰腺头部、... 目的采用化学位移MRI研究初诊2型糖尿病患者的胰腺脂肪含量及分布特点,并探讨胰腺与肝脏脂肪含量的相关性。方法征集初诊的2型糖尿病患者70例,采用化学位移双回波MRI技术分别测量胰腺头部、体部、尾部及肝脏的脂肪含量,比较胰腺头部、体部、尾部的脂肪含量差异,分析胰腺脂肪含量与肝脏脂肪含量的相关性。结果本组患者胰腺头部、体部、尾部的脂肪分数分别为5.59%±4.70%、4.80%±3.75%、4.88%±3.86%,三个区域的脂肪含量没有统计学差异(F=1.761,P>0.05)。胰腺的平均脂肪分数为5.15%±3.75%,肝脏为9.88%±3.19%,胰腺的脂肪含量与肝脏的脂肪含量没有相关性(r=0.053,P>0.05)。结论初诊的2型糖尿病患者胰腺头、体、尾部的脂肪含量较为一致,胰腺的脂肪含量与肝脏的脂肪含量不相关。 展开更多
关键词 2型糖尿病 化学位移MRI 胰腺脂肪含量 肝脏脂肪含量
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胰腺脂肪浸润的CT参数与2型糖尿病合并脑梗死的相关性研究 被引量:1
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作者 陆雨纯 应长江 +1 位作者 沃眉宏 孙莉 《医学研究杂志》 2023年第7期66-70,共5页
目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并脑梗死(cerebra infarction,CI)患者胰腺脂肪浸润(pancreatic steatosis,PS)的CT参数差异,及其与CI的相关性。方法连续性纳入2018年10月~2022年2月在徐州医科大学附属医院住院的T... 目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并脑梗死(cerebra infarction,CI)患者胰腺脂肪浸润(pancreatic steatosis,PS)的CT参数差异,及其与CI的相关性。方法连续性纳入2018年10月~2022年2月在徐州医科大学附属医院住院的T2DM患者152例,根据头颅CT结果按照是否合并CI分为两组,即单纯T2DM组(单纯组,n=44)及T2DM合并CI组(脑梗死组,n=108),同时选取同期体检的健康人群作为对照组(n=41)。收集纳入患者的临床资料,并检测胱抑素C(Cyc-C)、血脂等生化指标。在腹部CT平扫上测量胰腺及脾脏的CT密度(HU值),计算胰腺及脾脏平均值(P_(平均)、S_(平均)),并计算胰腺CT密度指数[胰腺与脾脏的密度差值(P-S)和胰腺与脾脏的密度比值(P/S)]。比较不同组间临床资料的差异,采用Logistic回归模型筛选T2DM合并CI的危险因素,选用受试者工作特征(receiver operator characteristic,ROC)曲线获得P/S的最佳截断值。结果3组患者P_(平均)、P-S、P/S比较,脑梗死组<单纯组<NC组,差异均有统计学意义(P<0.001),脑梗死组患者的胰头、胰体、胰尾CT值比较,差异均有统计学意义(P<0.001)。Logistic回归分析结果表明,P/S、Cys-C为影响T2DM患者发生CI的影响因素,校正混杂因素后,P/S与T2DM合并脑梗死仍具有相关性。ROC曲线分析结果显示,P/S预测CI的曲线下面积为0.731(95%CI:0.634~0.827,P<0.001);P/S预测脑梗死的最佳截断值为0.8467,对应的敏感度为80.6%,对应的特异性为61.4%。结论T2DM患者常存在PS,PS为T2DM患者合并脑梗死的危险因素,PS的严重程度对T2DM合并CI人群具有一定的预测价值。 展开更多
关键词 2型糖尿病 胰腺脂肪浸润 脑梗死 计算机断层扫描
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Enlarged pancreas: not always a cancer
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作者 Lucia Calculli Davide Festi Raffaele Pezzilli 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2015年第1期107-108,共2页
Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancreatic steatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy and nonalco... Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancreatic steatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy and nonalcoholic fatty pancreas disease. It has been reported to be associated with type 2 diabetes mellitus, acute pancreatitis, pancreatic cancer and the formation of pancreatic fistula. The real incidence of this condition is still unknown. We report a case of pancreatic steatosis in a non-obese female patient initially diagnosed with a mass in the head of the pancreas. Magnetic resonance imaging(MRI) was carried out to define the characteristics of the pancreatic mass. MRI confirmed the diagnosis of fat pancreas. Enlarged pancreas is not always a cancer, but pancreatic steatosis is characterized by pancreatic enlargement. MRI could give a definite diagnosis of pancreatic steatosis or cancer. 展开更多
关键词 pancreatic steatosis magnetic resonance image computer tomography IGG4 differential diagnosis clinical course
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