作　　者： (苏松）; (徐茂锦）; (赵安静）; (李映璇）; (高绥之）; (胡良皥）; (廖专）; (李兆申）;

机构地区： 军事医学科学院附属解放军307医院消化内科,北京100071 第二军医大学长海医院内分泌科

出　　处： 《中华胰腺病杂志》 2017年第4期238-242,共5页

摘　　要： 目的检测慢性胰腺炎（CP）患者胰腺相关性内分泌激素的代谢水平，探讨这些激素在CP并发糖尿病过程中的作用。 方法按照纳入和排除标准，连续性纳入2016年2月至2016年8月间第二军医大学长海医院消化内科收治的CP患者，以年龄、性别相匹配的体检健康者作为对照组。CP患者根据基本资料以及检测指标又分为CP糖代谢异常组和CP糖代谢正常组；酒精性CP组和非酒精性CP组。检测空腹血糖、三酰甘油（TG）、总胆固醇（TC）、胰高血糖素样肽-1（GLP-1）、胰多肽（PP）、胰高血糖素、胰泌素、生长抑素水平，分析比较各组间的差异。 结果最终纳入CP患者53例，健康对照者8例；CP糖代谢异常34例，CP糖代谢正常19例；酒精性CP 19例，非酒精性CP 34例。CP组患者空腹血糖高于对照组[（6.69±2.57）mmol/L比（5.42±0.40）mmol/L]，胰泌素水平低于对照组[（10.1±3.7）ng/L比（18.2±4.6）ng/L]，差异均有统计学意义（P值均〈0.05）；与CP糖代谢正常组比较，CP糖代谢异常组饮酒人数多（47.1%比15.8%），空腹血糖[（7.79±2.60）mmol/L比（4.71±0.42）mmol/L]及GLP-1水平高（112±24）ng/L比（97±25）ng/L], TG[（1.23±0.55）mmol/L比（1.71±0.99）mmol/L]及生长抑素水平低[（44.8±7.6）mmol/L比（47.1±7.3）mmol/L]，差异均有统计学意义（P值均〈0.05）；酒精性CP组男性占比（100%比58.8%）、糖代谢异常发生率（84.2%比52.9%）显著高于非酒精性CP组，差异均有统计学意义（P〈0.05或〈0.01）。其他指标各组间的差异均无统计学意义。 结论CP患者除胰岛功能异常外，常合并胰泌素、GLP-1、生长抑素等内分泌激素代谢的异常。长期大量饮酒与CP并发糖代谢异常具有明显的相关性。 Objectiveto determine the basal levels of several pancreas-related endocrine hormones in patients with chronic pancreatitis. Methodsaccording to inclusion and exclusion criteria, consecutive patients from February 2016 to August 2016 in Department of Gastroenterology, Changhai Hospital, Second Military Medical University and ten healthy control （matched for age and gender） were included. Basal levels of glucagon-like peptide 1, pancreatic polypeptide, Secretin, glucagon, somatostatin between groups of CP vs healthy control, CP with abnormal glycometabolism vs CP with normal glycometabolism and alcoholic CP vs non-alcoholic CP were compared. Resultsa total of 53 patients with chronic pancreatitis and 8 healthy subjects were included in this study. （1）CP vs healthy controls： the level of secretin in healthy control patients is significant lower than that in CP patients; （2）CP with abnormal glycometabolism vs CP with normal glycome-tabolism： the level of triglyceride and somatostatin is significant lower than that in CP patients; the prevalence of patients with chronic alcohol consumption and the level of glucagon-like peptide 1 in CP with abnormal glycometabolism is significant higher than that in CP with normal glycometabolism; （3） the prevalence of abnormal glycometabolism in alcoholic CP group is significant higher than that in non-alcoholic CP. The results above are all of statistical significance. Conclusionsin addition to dysfunction of islets/β-cells, CP also easily affects the level of other pancreas-related hormones such as secretin, somatostatin and glucagon-like peptide 1. Otherwise, chronic alcohol consumption is also strongly related with abnormal glycometabolism, the mechanism deserves further researches.

关 键 词： 胰腺炎 慢性 胰腺激素类 葡萄糖代谢障碍 饮酒