儿童从急性胰腺炎发展为慢性胰腺炎:系统性审查和元分析
Endre Botond Gagyi1,2,3, Mahmoud Obeidat1, Edina Tari1,4
1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Clinical and experimental pediatrics
|December 11, 2025
概括
大约18%的儿童在初始发作后出现复发性急性胰腺炎 (RAP),其中35%的儿童发展为慢性胰腺炎 (CP). 病因,严重程度,结构和遗传因素影响这些儿科胰腺炎进展风险.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 胰腺学 胰腺学
- 临床流行病学临床流行病学
背景情况:
- 儿童的急性胰腺炎 (AP) 可以导致复发性胰腺炎 (RAP) 或慢性胰腺炎 (CP).
- 了解进展率和风险因素对于儿科AP管理至关重要.
研究的目的:
- 在儿科群体中量化从初始AP到RAP和CP的进展率.
- 确定与AP进展相关的临床,结构和遗传风险因素.
主要方法:
- 来自PubMed/MEDLINE,Embase和Cochrane数据库的观察性研究的系统审查和元分析.
- 包括的研究报告了儿科患者的RAP或CP进展.
- 使用随机效应模型组合比例和赔率比率 (ORs);用I2统计数据评估异质性.
主要成果:
- 18%的儿童在第一个AP插曲后发展为RAP;10%的儿童发展为CP.
- 在患有RAP的儿童中,有35%的儿童发展为CP.
- 随着病因 (例如,高甘油三血症33%) 和严重程度 (严重39%) 的不同,RAP的发病率有所不同.
- 结构异常 (OR 3.15),胰腺分裂 (OR 2.64) 和PRSS1突变 (OR 4.56) 与发展为RAP/CP.相关.
结论:
- 儿科AP复发是显著的,其中很大一部分进展为慢性疾病.
- 最初的AP事件特征 (病因,严重程度) 影响RAP风险.
- 结构性和遗传因素是长期进展到CP的关键预测因素.
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