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急性胰腺炎的病因

Author
Santhi Swaroop Vege, MD
Section Editor
David C Whitcomb, MD, PhD
Deputy Editor
Shilpa Grover, MD, MPH, AGAF
Translators
白鹏, 主治医师

引言

急性胰腺炎是胰腺的一种炎症性疾病，其临床特征为腹痛和血液中的胰酶水平升高[1,2]。急性胰腺炎的发病机制尚不完全清楚。然而，已知多种疾病都可诱发该病(对这种关联的确定程度各不相同)，美国2/3或以上的病例都是由胆石和长期酗酒引起的(表 1)。毫无疑问，胰腺炎的病因会越来越多地被发现，随着对该病的进一步了解，诊断为“特发性”胰腺炎的病例数则会逐渐减少。

本专题将讨论急性胰腺炎的病因。急性胰腺炎的临床表现、诊断、一般治疗原则及发病机制将单独讨论。 (参见“急性胰腺炎严重程度的预测”和“急性胰腺炎的治疗”和“胰腺清创术”和“急性胰腺炎的发病机制”)

发病率和死亡率

很难准确地评估急性胰腺炎的发病率和死亡率，因为轻度胰腺炎可能没有典型的临床症状，而重症和暴发病例可能在诊断前患者就已死亡。

据报道，急性胰腺炎的年发病率为(4.9-35)例/10万人[3]。在美国，急性胰腺炎是导致住院的主要胃肠道原因[4]。由于饮酒增多和诊断能力提高，许多欧洲国家和斯堪的纳维亚国家中的急性胰腺炎发病率逐渐增加[5]。一项来自荷兰的回顾性研究发现，1985年-1995年间，急性胰腺炎的发病率增加了28%。

诊断性和治疗性干预措施的进展使急性胰腺炎的死亡率有所降低，尤其是重症(常为坏死性)胰腺炎患者。急性胰腺炎患者在最初2周内的死因通常是全身炎症反应综合征和器官衰竭，而2周后的死因通常是脓毒症及其并发症[6,7]。

                        

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Literature review current through: 2017-06 . | This topic last updated: 2015-05-07.
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