Risk factors of chronic pancreatitis
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摘要: 慢性胰腺炎病因复杂。近年来针对慢性胰腺炎的流行病学研究发现,慢性胰腺炎发病率逐年升高且病因构成发生改变。酒精虽然仍是导致慢性胰腺炎最常见的危险因素,但其比例显著下降,酒精摄入量与慢性胰腺炎的患病风险密切相关。长期吸烟也被认为是慢性胰腺炎相关的独立危险因素。其他病因如遗传性、自身免疫性及特发性慢性胰腺炎等发病率较前增加。在我国,酒精已超越胆道疾病成为慢性胰腺炎的主要病因。Abstract: Risk factors of chronic pancreatitis (CP) are complex.Many epidemiology studies have been reported that there were an increased incident rate and alternation of etiology of CP in recent years.The prevalence of alcohol consumption, which is still the most important risk factor for CP, has been declined.When stratified by drinking status, very heavy alcohol consumption has been demonstrated to be significantly associated with CP.In addition, cigarette smoking is also a dose-dependent, independent risk factor of CP.Other types of CP, such as hereditary, autoimmune and idiopathic CP, also increased recently.In our country, alcohol intake, but not biliary tract disease or gallstone, has become the most common cause of CP.
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Key words:
- pancreatitis /
- chronic /
- risk factors
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[1]Frulloni L, Gabbrielli A, Pezzilli R, et al.Chronic pancreatitis:report from a multicenter Italian survey (PanCroInfAISP) on893 patients[J].Dig Liver Dis, 2009, 41 (4) :311-317. [2]Yadav D, Whitcomb DC.The role of alcohol and smoking inpancreatitis[J].Nat Rev Gastroenterol Hepatol, 2010, 7 (3) :131-145. [3]王洛伟, 李兆申, 李淑德, 等.慢性胰腺炎全国多中心流行病学调查[J].胰腺病学, 2007, 7 (1) :1-5. [4]Cote GA, Yadav D, Slivka A, et al.Alcohol and smoking asrisk factors in an epidemiology study of patients with chronicpancreatitis[J].Clin Gastroenterol Hepatol, 2011, 9 (3) :266-273, e27. [5]Witt H, Apte MV, Keim V, et al.Chronic pancreatitis:chal-lenges and advances in pathogenesis, genetics, diagnosis, and therapy[J].Gastroenterology, 2007, 132 (4) :1557-1573. [6]Yadav D, Hawes RH, Brand RE, et al.Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronicpancreatitis[J].Arch Intern Med, 2009, 169 (11) :1035-1045. [7]Kristiansen L, Gronbaek M, Becker U, et al.Risk of pancre-atitis according to alcohol drinking habits:a population-based cohort study[J].Am J Epidemiol, 2008, 168 (8) :932-937. [8]Yadav D, Slivka A, Sherman S, et al.Smoking is underrec-ognized as a risk factor for chronic pancreatitis[J].Pancre-atology, 2010, 10 (6) :713-719. [9]Tolstrup JS, Kristiansen L, Becker U, et al.Smoking andrisk of acute and chronic pancreatitis among women andmen:a population-based cohort study[J].Arch InternMed, 2009, 169 (6) :603-609. [10]Andriulli A, Botteri E, Almasio PL, et al.Smoking as a cofac-tor for causation of chronic pancreatitis:a meta-analysis[J].Pancreas, 2010, 39 (8) :1205-1210. [11]Maisonneuve P, Lowenfels AB, Mullhaupt B, et al.Ciga-rette smoking accelerates progression of alcoholic chronicpancreatitis[J].Gut, 2005, 54 (4) :510-514. [12]Katz M, Carangelo R, Miller LJ, et al.Effect of ethanol oncholecystokinin-stimulated zymogen conversion in pancreat-ic acinar cells[J].Am J Physiol, 1996, 270 (1 Pt 1) :G171-G175. [13]Pandol SJ, Periskic S, Gukovsky I, et al.Ethanol diet increa-ses the sensitivity of rats to pancreatitis induced by cholecys-tokinin octapeptide[J].Gastroenterology, 1999, 117 (3) :706-716. [14]Lu Z, Karne S, Kolodecik T, et al.Alcohols enhance caer-ulein-induced zymogen activation in pancreatic acinar cells[J].Am J Physiol Gastrointest Liver Physiol, 2002, 282 (3) :G501-G507. [15]Apte MV, Phillips PA, Fahmy RG, et al.Does alcohol direct-ly stimulate pancreatic fibrogenesis?Studies with rat pancre-atic stellate cells[J].Gastroenterology, 2000, 118 (4) :780-794. [16]Bachem MG, Zhou Z, Zhou S, et al.Role of stellate cells inpancreatic fibrogenesis associated with acute and chronicpancreatitis[J].J Gastroenterol Hepatol, 2006, 21 (Suppl3) :S92-S96. [17]Comfort MW, Steinberg AG.Pedigree of a family with he-reditary chronic relapsing pancreatitis[J].Gastroenterology, 1952, 21 (1) :54-63. [18]Le Bodic L, Bignon JD, Raguenes O, et al.The hereditarypancreatitis gene maps to long arm of chromosome 7[J].Hum Mol Genet, 1996, 5 (4) :549-554. [19]Whitcomb DC, Gorry MC, Preston RA, et al.Hereditary pan-creatitis is caused by a mutation in the cationic trypsinogengene[J].Nat Genet, 1996, 14 (2) :141-145. [20]Teich N, Mossner J.Hereditary chronic pancreatitis[J].BestPract Res Clin Gastroenterol, 2008, 22 (1) :115-130. [21]Ooi CY, Dorfman R, Cipolli M, et al.Type of CFTR mutationdetermines risk of pancreatitis in patients with cystic fibrosis[J].Gastroenterology, 2011, 140 (1) :153-161. [22]Schneider A, Larusch J, Sun X, et al.Combined bicarbonate conductance-impairing variants in CFTR and SPINK1 vari-ants are associated with chronic pancreatitis in patients with-out cystic fibrosis[J].Gastroenterology, 2011, 140 (1) :162-171. [23]Finkelberg DL, Sahani D, Deshpande V, et al.Autoimmunepancreatitis[J].N Engl J Med, 2006, 355 (25) :2670-2676. [24]Keller J, Layer P.Idiopathic chronic pancreatitis[J].BestPract Res Clin Gastroenterol, 2008, 22 (1) :105-113. [25]Castellani C, Lira MG, Frulloni L, et al.Analysis of the entirecoding region of the cystic fibrosis transmembrane regulatorgene in idiopathic pancreatitis[J].Hum Mutat, 2001, 18 (2) :166. [26]Cohn JA, Friedman KJ, Noone PG, et al.Mutations of thecystic fibrosis gene, but not cationic trypsinogen gene, areassociated with recurrent or chronic idiopathic pancreatitis[J].Am J Gastroenterol, 2000, 95 (8) :2061-2067. [27]Sharer N, Schwarz M, Malone G, et al.Mutations of thecystic fibrosis gene in patients with chronic pancreatitis[J].N Engl J Med, 1998, 339 (10) :645-652.
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