高 帆， 祁興順， 侯 悅， 郭曉鐘

(1 解放軍第二〇二醫(yī)院 醫(yī)務(wù)處， 沈陽 110003； 2 沈陽軍區(qū)總醫(yī)院 消化內(nèi)科， 沈陽 110840)

胰腺炎與脂肪肝的關(guān)系探討

高 帆1， 祁興順2， 侯 悅2， 郭曉鐘2

(1 解放軍第二〇二醫(yī)院 醫(yī)務(wù)處， 沈陽 110003； 2 沈陽軍區(qū)總醫(yī)院 消化內(nèi)科， 沈陽 110840)

胰腺炎系一種常見的、病死率高的消化系統(tǒng)疾病。臨床醫(yī)生常會遇到胰腺炎合并脂肪肝的患者。從脂肪肝在胰腺炎患者中的患病率、脂肪肝對胰腺炎預(yù)后的影響、妊娠急性脂肪肝誘發(fā)胰腺炎3個方面進(jìn)行了闡述，以探討胰腺炎與脂肪肝之間的關(guān)系。

胰腺炎； 脂肪肝； 預(yù)后

胰腺炎為常見的消化系統(tǒng)疾病[1-3]，其中急性胰腺炎的年發(fā)病率為13/10萬～45/10萬[4-5]，而慢性胰腺炎的年發(fā)病率為5/10萬～12/10萬[6-9]。在美國，急性胰腺炎居院內(nèi)死亡原因的第5位[2]；在英國，重癥急性胰腺炎的院內(nèi)死亡率可達(dá)15%～20%[10]。至今，國內(nèi)外專家已針對胰腺炎管理方面制訂了多部臨床實踐指南或共識[11-25]。胰腺炎的主要病因包括膽石癥、高三酰甘油血癥、酗酒等(表1)。目前，尚無指南或共識將脂肪肝列為胰腺炎的危險因素或病因。然而，在臨床工作中，經(jīng)常會遇到胰腺炎合并脂肪肝的患者[26](圖1)。筆者通過PubMed及CNKI數(shù)據(jù)庫以“pancreatitis”及“fatty liver”或“胰腺炎”及“脂肪肝”作為檢索詞鑒定相關(guān)文獻(xiàn)，從脂肪肝在胰腺炎的患病率、脂肪肝對胰腺炎預(yù)后的影響、妊娠急性脂肪肝誘發(fā)胰腺炎3個主要方面進(jìn)行闡述，以探討胰腺炎與脂肪肝之間的關(guān)系。

1 脂肪肝在胰腺炎患者中的患病率

胰腺炎患者常伴有脂肪肝。有研究[27-34]報道了脂肪肝在不同類型胰腺炎患者中的患病率情況(表2)。根據(jù)急性胰腺炎的病因，高脂血癥性急性胰腺炎患者比非高脂血癥性急性胰腺炎患者有著更高的脂肪肝患病率[30-31,34]。相似地，急性胰腺炎伴有脂肪肝患者比無脂肪肝患者的甘油三酯水平更高[34]。這證明了在急性胰腺炎患者中血脂水平與脂肪肝之間的密切關(guān)系。此外，考慮到高脂血癥系急性胰腺炎的確切病因，似乎可以合理地推測脂肪肝也可能是胰腺炎的誘因。然而，最近的證據(jù)提示，在重度高脂血癥患者(甘油三酯≥1000 mg/dl)中，脂肪肝與急性胰腺炎的發(fā)生也許并無顯著關(guān)系。Tada等[29]回顧性分析了215例重度高脂血癥患者的臨床特征，急性胰腺炎患者中脂肪肝患病率為50%(6/12)，而無急性胰腺炎患者中脂肪肝患病率為55.7%(113/203)，兩組差異無統(tǒng)計學(xué)意義。然而，由于該研究僅包括12例急性胰腺炎患者，且兩組間基線特征的均衡性不明，因此尚需進(jìn)一步大樣本研究來證實這一觀點。但該研究卻證實了血脂水平與急性胰腺炎風(fēng)險呈正相關(guān)。急性胰腺炎患者較無急性胰腺炎患者有著更高的甘油三酯水平[(1872±1069)mg/dl vs (1440±625) mg/dl]，兩組差異有統(tǒng)計學(xué)意義(P=0.028)。Xiao等[32]通過分析50例急性胰腺炎患者的MR特征變化也發(fā)現(xiàn)，隨著急性胰腺炎患者的甘油三酯水平下降，MR所示脂肪肝的程度也有所改善。因此，脂肪肝對急性胰腺炎發(fā)生的影響可能是依賴于甘油三酯水平改變。根據(jù)急性胰腺炎的嚴(yán)重程度，重癥急性胰腺炎患者比非重癥急性胰腺炎患者有著更高的脂肪肝患病率。Xiao等[32]發(fā)現(xiàn)，重癥急性胰腺炎患者中脂肪肝患病率為100%，而輕度急性胰腺炎患者中脂肪肝患病率為59%。Xu等[34]研究發(fā)現(xiàn)，伴有脂肪肝的患者較無脂肪肝的患者更常發(fā)生中重度和重癥急性胰腺炎(30.42% vs 17.89%；15.83% vs 6.66%)；根據(jù)增強(qiáng)CT表現(xiàn)，伴有脂肪肝的患者也更常發(fā)生壞死型急性胰腺炎(38.33% vs 17.62%)。此外，脂肪肝的嚴(yán)重程度與急性胰腺炎的嚴(yán)重程度也密不可分。

圖1 急性胰腺炎合并脂肪肝的患者治療前后的CT比較 a,b: 入院時CT平掃，胸腔積液，肝周積液，急性胰腺炎，胰周滲出，脂肪肝(肝/脾CT值<1);c，d:治療后CT平掃，胸腔積液消失，肝周積液消失，空腸營養(yǎng)管置入，胰周滲液吸收，脂肪肝程度降低(肝/脾CT值>1)

表1 胰腺炎指南或共識中提及的病因

表2 脂肪肝在胰腺炎患者中的患病率

注：1)胰腺疾病患者

慢性胰腺炎可導(dǎo)致胰頭部組織發(fā)生纖維化，進(jìn)而造成胰管與膽總管共同開口處局部梗阻及膽汁淤積，最終發(fā)生肝纖維化，甚至繼發(fā)性膽汁淤積性肝硬化。此外，酒精性慢性胰腺炎也可同時發(fā)生酒精性脂肪肝或肝硬化。脂肪肝在慢性胰腺炎患者中的患病率約為36.7%～72.0%。Beer等[27]通過應(yīng)用瞬時彈性成像技術(shù)評估54例慢性胰腺炎患者發(fā)現(xiàn)，酒精性慢性胰腺炎患者比特發(fā)性慢性胰腺炎有著更高的脂肪肝患病率，但差異無統(tǒng)計學(xué)意義。

2 脂肪肝對胰腺炎預(yù)后的影響

脂肪肝與急性胰腺炎預(yù)后有著密切的關(guān)系。Xu等[34]回顧性分析了2671例急性胰腺炎患者的臨床特征、并發(fā)癥以及病死率。急性胰腺炎伴有脂肪肝的患者較無脂肪肝的患者更常發(fā)生局部并發(fā)癥(22.08% vs 10.81%)、全身并發(fā)癥(40.42% vs 16.07%)、呼吸衰竭(34.38% vs 13.37%)、腎衰竭(11.46% vs 4.43%)、全身炎癥反應(yīng)綜合征(38.13% vs 17.89%)、感染(46.46% vs 37.7%)，差異均有統(tǒng)計學(xué)意義。更為重要的是，研究者也發(fā)現(xiàn)，脂肪肝與死亡也密切相關(guān)(6.46% vs 1.69%)。基于這些研究結(jié)果，應(yīng)在急性胰腺炎患者入院時鑒定是否存在脂肪肝及其嚴(yán)重程度，以初步評估預(yù)后。未來研究也有必要進(jìn)一步探討脂肪肝作為單一預(yù)后因素或聯(lián)合傳統(tǒng)預(yù)后評分(Ranson、BISAP、APACHE等)的價值。

3 妊娠期急性脂肪肝與胰腺炎

妊娠期并發(fā)急性胰腺炎已被廣泛報道，其發(fā)病率為1/1000～1/3000，其主要誘因與非妊娠期急性胰腺炎相似。相比之下，妊娠期急性脂肪肝與急性胰腺炎的關(guān)系少有報道。

妊娠期急性脂肪肝常發(fā)生在妊娠晚期，發(fā)病率為1/7000～1/16 000，孕婦病死率為7%～18%，胎兒病死率為9%～23%[35-37]。長鏈-3-羥?；o酶A脫氫酶及其相關(guān)編碼基因突變可導(dǎo)致胎兒線粒體脂肪酸β氧化缺陷，進(jìn)而增加妊娠期急性脂肪肝發(fā)病風(fēng)險。此病常在并發(fā)癥出現(xiàn)時才得以診斷。主要的并發(fā)癥包括肝性腦病、低血糖、腎衰竭、彌漫性血管內(nèi)凝血、先兆子癇等。目前，也有學(xué)者[38-45]報道了妊娠期急性脂肪肝誘發(fā)急性胰腺炎的個案(表3)。其可能的發(fā)病機(jī)制包括：(1)妊娠期雌激素增加，繼而導(dǎo)致高脂血癥；(2)孕激素增加，繼而導(dǎo)致脂肪酶及胰蛋白酶分泌增加，同時可導(dǎo)致Oddi氏括約肌痙攣和胰管壓力過低；(3)免疫因素[42]。Moldenhauer等[46]對15例妊娠期急性脂肪肝誘發(fā)急性胰腺炎患者進(jìn)行分析顯示，平均孕婦年齡為26.3歲(21～37歲)；以持續(xù)性惡心、嘔吐為主要臨床表現(xiàn)；11例患者伴有淀粉酶升高，另外1例患者伴有脂肪酶升高；8例行影像學(xué)檢查的患者中，7例患者存在胰腺炎的影像學(xué)表現(xiàn)；主要合并疾病包括腦病、急性呼吸窘迫綜合征、腎衰竭；孕婦病死率為17%(2/15)。

表3 妊娠期急性脂肪肝誘發(fā)胰腺炎的個案匯總

4 結(jié)語

脂肪肝在胰腺炎患者中較常見，且可增加胰腺炎相關(guān)并發(fā)癥的發(fā)生風(fēng)險及病死率。另外，雖然妊娠期急性脂肪肝誘發(fā)的胰腺炎罕見，但一旦發(fā)生，患者預(yù)后極差。因此，臨床醫(yī)生應(yīng)加強(qiáng)對脂肪肝與胰腺炎之間關(guān)系的認(rèn)識，積極防治脂肪肝也許有助于降低胰腺炎的發(fā)病風(fēng)險并改善預(yù)后。

[1] FORSMARK CE, VEGE SS, WILCOX CM. Acute pancreatitis[J]. N Engl J Med, 2016, 375(20): 1972-1981.

[2] LANKISCH PG, APTE M, BANKS PA. Acute pancreatitis[J]. Lancet, 2015, 386(9988): 85-96.

[3] MAJUMDER S, CHARI ST. Chronic pancreatitis[J]. Lancet, 2016, 387(10031): 1957-1966.

[4] SATOH K, SHIMOSEGAWA T, MASAMUNE A, et al. Nationwide epidemiological survey of acute pancreatitis in Japan[J]. Pancreas, 2011, 40(4): 503-507.

[5] SHEN HN, LU CL, LI CY. Epidemiology of first-attack acute pancreatitis in Taiwan from 2000 through 2009: a nationwide population-based study[J]. Pancreas, 2012, 41(5): 696-702.

[6] HIROTA M, SHIMOSEGAWA T, MASAMUNE A, et al. The sixth nationwide epidemiological survey of chronic pancreatitis in Japan[J]. Pancreatology, 2012, 12(2): 79-84.

[7] ZHANG ZG, GEN XP. Interpretation of the 2013 International Association of Pancreatology/American Pancreas Association evidence-based guidelines for the management of acute pancreatitis (Ⅰ)[J]. J Hepatobiliary Surg, 2013, 21(5): 385-388. (in Chinese) 張志功, 耿小平. 2013年國際胰腺協(xié)會/美國胰腺協(xié)會循證醫(yī)學(xué)基礎(chǔ)上的急性胰腺炎處理指南解讀(一)[J]. 肝膽外科雜志, 2013, 21(5): 385-388.

[8] ZHANG ZG, GEN XP. Interpretation of the 2013 International Association of Pancreatology/American Pancreas Association evidence-based guidelines for the management of acute pancreatitis (Ⅱ)[J]. J Hepatobiliary Surg, 2013, 21(6): 467-470. (in Chinese) 張志功, 耿小平. 2013年國際胰腺協(xié)會/美國胰腺協(xié)會循證醫(yī)學(xué)基礎(chǔ)上的急性胰腺炎處理指南解讀(二)[J]. 肝膽外科雜志, 2013, 21(6): 467-470.

[9] ZHANG ZG, GEN XP. Interpretation of the 2013 International Association of Pancreatology/American Pancreas Association evidence-based guidelines for the management of acute pancreatitis (Ⅲ)[J]. J Hepatobiliary Surg, 2014, 22(1): 62-65. (in Chinese) 張志功, 耿小平. 2013年國際胰腺協(xié)會/美國胰腺協(xié)會循證醫(yī)學(xué)基礎(chǔ)上的急性胰腺炎處理指南解讀(三)[J]. 肝膽外科雜志, 2014, 22(1): 62-65.

[10] JOHNSON CD, BESSELINK MG, CARTER R. Acute pancreatitis[J]. BMJ, 2014, 349: g4859.

[11] Italian Association for the Study of the Pancreas (AISP), PEZZILLI R, ZERBI A, et al. Consensus guidelines on severe acute pancreatitis[J]. Dig Liver Dis, 2015, 47(7): 532-543.

[12] HUANG GW, SHEN DC. Interpretation of consensus guidelines for severe acute pancreatitis (2015) in Italy[J]. Chin J Gen Surg, 2016, 25(3): 313-317. (in Chinese) 黃耿文, 申鼎成. 意大利重癥急性胰腺炎共識指南(2015)解讀[J]. 中國普通外科雜志, 2016, 25(3): 313-317.

[13] ISAJI S, TAKADA T, MAYUMI T, et al. Revised Japanese guidelines for the management of acute pancreatitis 2015: revised concepts and updated points[J]. J Hepatobiliary Pancreat Sci, 2015, 22(6): 433-445.

[14] The Spleen and Stomach Disease Branch of China Association of Chinese Medicine. Consensus on acute pancreatitis management of Chinese medicine[J]. China J Tradit Chin Med Pharma, 2013, 28(6): 1826-1831. (in Chinese) 中華中醫(yī)藥學(xué)會脾胃病分會. 急性胰腺炎中醫(yī)診療專家共識意見[J]. 中華中醫(yī)藥雜志, 2013, 28(6): 1826-1831.

[15] ITO T, ISHIGURO H, OHARA H, et al. Evidence-based clinical practice guidelines for chronic pancreatitis 2015[J]. J Gastroenterol, 2016, 51(2): 85-92.

[16] LI XQ, QIAN JM. An excerpt of evidence-based clinical practice guidelines for chronic pancreatitis by Japanese Society of Gastroenterology in 2015[J]. J Clin Hepatol, 2016, 32(5): 857-859. (in Chinese) 李曉青, 錢家鳴. 《2015年日本胃腸病學(xué)會慢性胰腺炎循證臨床實踐指南》摘譯[J]. 臨床肝膽病雜志, 2016, 32(5): 857-859.

[17] SUN B, ZHAO ZJ. The interpretation of the evidence-based clinical practice guidelines for chronic pancreatitis by Japanese Society of Gastroenterology in 2015[J]. Chin J Pract Surg, 2016, 36(3): 305-308. (in Chinese) 孫備, 趙忠杰. 日本胃腸病學(xué)會《慢性胰腺炎循證臨床實踐指南(2015)》解讀[J]. 中國實用外科雜志, 2016, 36(3): 305-308.

[18] Professional Committee of Pancreatic Disease, Chinese Medical Doctor Association. Chinese consensus on the multidisciplinary treatment (MDT) of acute pancreatitis[J]. J Clin Hepatol, 2015, 31(11): 1770-1775. (in Chinese) 中國醫(yī)師協(xié)會胰腺病學(xué)專業(yè)委員會. 中國急性胰腺炎多學(xué)科診治共識意見[J]. 臨床肝膽病雜志, 2015, 31(11): 1770-1775.

[19] Pancreatology Committee of Chinese Medical Doctor Association. Chinese consensus on acute pancreatitis by multiple discipline team (Draft)[J]. Chin J Pract Intern Med, 2015, 35(12): 1004-1010. (in Chinese) 中國醫(yī)師協(xié)會胰腺病學(xué)專業(yè)委員會. 中國急性胰腺炎多學(xué)科診治(MDT)共識意見(草案)[J]. 中國實用內(nèi)科雜志, 2015, 35(12): 1004-1010.

[20] BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111.

[21] LENG F, YANG L, CHANG ZG, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus[J]. J Clin Hepatol, 2013, 29(4):Ⅰ-Ⅶ. (in Chinese) 冷芳, 楊力, 常志剛, 等. 急性胰腺炎分類——2012：亞特蘭大分類和定義修訂的國際共識[J]. 臨床肝膽病雜志, 2013, 29(4):Ⅰ-Ⅶ.

[22] Group of Pancreas Surgery, Chinese Society of Surgery, Chinese Medical Association. Guidelines for the management of chronic pancreatitis(2014)[J]. J Clin Hepatol, 2015, 31(3): 322-326. (in Chinese) 中華醫(yī)學(xué)會外科學(xué)分會胰腺外科學(xué)組. 慢性胰腺炎診治指南(2014)[J]. 臨床肝膽病雜志, 2015, 31(3): 322-326.

[23] Group of Pancreas Surgery, Chinese Society of Surgery, Chinese Medical Association. Guidelines for the management of acute pancreatitis(2014)[J]. J Clin Hepatol, 2015, 31(1): 17-20. (in Chinese) 中華醫(yī)學(xué)會外科學(xué)分會胰腺外科學(xué)組. 急性胰腺炎診治指南(2014)[J]. 臨床肝膽病雜志, 2015, 31(1): 17-20.

[24] Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association, Editorial Board of Chinese Journal of Pancreatology, Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis (Shanghai, 2013)[J]. J Clin Hepatol, 2013, 29(9): 656-660. (in Chinese) 中華醫(yī)學(xué)會消化病學(xué)分會胰腺疾病學(xué)組,《中華胰腺病雜志》編輯委員會,《中華消化雜志》編輯委員會. 中國急性胰腺炎診治指南(2013年，上海)[J]. 臨床肝膽病雜志, 2013, 29(9): 656-660.

[25] Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association. Chinese guidelines for the management of acute pancreatitis (draft)[J]. Chin J Dig, 2004, 24(3): 62-64. (in Chinese) 中華醫(yī)學(xué)會消化病學(xué)分會胰腺疾病學(xué)組. 中國急性胰腺炎診治指南(草案)[J]. 中華消化雜志, 2004, 24(3): 62-64.

[26] QI X, HOU Y, GUO X. Severe fatty liver disease and acute pancreatitis: is there a correlation between them?[J]. Clin Exp Hepatol, 2016, 1(4): 127-130.

[27] BEER S, WIEGAND J, ROSENDAHL J, et al. High prevalence of fatty liver disease and fibrosis in patients with chronic pancreatitis[J]. Gastroenterology, 2016, 150(4): s908.

[28] CHARLESWORTH A, STEGER A, CROOK MA. Acute pancreatitis associated with severe hypertriglyceridaemia; A retrospective cohort study[J]. Int J Surg, 2015, 23(Pt A): 23-27.[29] TADA H, KAWASHIRI MA, NAKAHASHI T, et al. Clinical characteristics of Japanese patients with severe hypertriglyceridemia[J]. J Clin Lipidol, 2015, 9(4): 519-524.[30] YIN G, HU G, CANG X, et al. C-reactive protein: rethinking its role in evaluating the severity of hyperlipidemic acute pancreatitis[J]. Pancreas, 2014, 43(8): 1323-1328.

[31] YIN G, CANG X, YU G, et al. Different clinical presentations of hyperlipidemic acute pancreatitis: a retrospective study[J]. Pancreas, 2015, 44(7): 1105-1110.

[32] XIAO B, ZHANG XM, JIANG ZQ, et al. Fatty liver in acute pancreatitis: characteristics in magnetic resonance imaging[J]. J Comput Assist Tomogr, 2012, 36(4): 400-405.

[33] FROSSARD JL, GIOSTRA E, RUBBIA-BRANDT L, et al. The role of transient elastography in the detection of liver disease in patients with chronic pancreatitis[J]. Liver Int, 2013, 33(7): 1121-1127.

[34] XU C, QIAO Z, LU Y, et al. Influence of fatty liver on the severity and clinical outcome in acute pancreatitis[J]. PLoS One, 2015, 10(11): e0142278.

[35] LIU MM, JIA SN, ZHANG Q, et al. Advances in clinical research on liver disease during pregnancy[J]. J Clin Hepatol, 2016, 32(2): 386-389. (in Chinese) 劉苗苗, 賈勝男, 張倩, 等. 妊娠期肝病的臨床研究進(jìn)展[J]. 臨床肝膽病雜志, 2016, 32(2): 386-389.

[36] ZHANG J, XU M, WANG XZ, et al. Liver disease during pregnancy[J]. J Clin Hepatol, 2008, 24(5): 397-399. (in Chinese) 張健, 徐敏, 王心竹, 等. 妊娠期肝病[J]. 臨床肝膽病雜志, 2008, 24(5): 397-399.

[37] Italian Association for the Study of the Liver (AISF), Italian Association for the Study of the Liver AISF. AISF position paper on liver disease and pregnancy[J]. Dig Liver Dis, 2016, 48(2): 120-137.

[38] HATFIELD AK, STEIN JH, GREENBERGER NJ, et al. Idiopathic acute fatty liver of pregnancy. Death from extrahepatic manifestations[J]. Am J Dig Dis, 1972, 17(2): 167-178.

[39] MINAKAMI H, KIMURA K, KANAZAWA T, et al. Acute fatty liver of pregnancy with hyperlipidemia, acute hemorrhagic pancreatitis and disseminated intravascular coagulation[J]. Asia Oceania J Obstet Gynaecol, 1985, 11(3): 371-376.

[40] MINAKAMI H, KIMURA K, TAMADA T, et al. Acute fatty liver of pregnancy: report of a case complicating DIC and acute pancreatitis (author′s transl)[J]. Nihon Sanka Fujinka Gakkai Zasshi, 1982, 34(5): 637-640.

[41] OCKNER SA, BRUNT EM, COHN SM, et al. Fulminant hepatic failure caused by acute fatty liver of pregnancy treated by orthotopic liver transplantation[J]. Hepatology, 1990, 11(1): 59-64.

[42] CRUCIAT G, STAMATIAN F, PUSCAS M, et al. Acute pancreatitis in a pregnant woman with acute fatty liver dystrophy. A case report[J]. J Gastrointestin Liver Dis, 2007, 16(2): 193-196.

[43] APIRATPRACHA W, YOSHIDA EM, SCUDAMORE CH, et al. Chronic pancreatitis: a sequela of acute fatty liver of pregnancy[J]. Hepatobiliary Pancreat Dis Int, 2008, 7(1): 101-104.

[44] KIRKLAND EB, SACHDEV R, KIM J, et al. Early pancreatic panniculitis associated with HELLP syndrome and acute fatty liver of pregnancy[J]. J Cutan Pathol, 2011, 38(10): 814-817.

[45] de OLIVEIRA CV, MOREIRA A, BAIMA JP, et al. Acute fatty liver of pregnancy associated with severe acute pancreatitis: a case report[J]. World J Hepatol, 2014, 6(7): 527-531.

[46] MOLDENHAUER JS, O'BRIEN JM, BARTON JR, et al. Acute fatty liver of pregnancy associated with pancreatitis: a life-threatening complication[J]. Am J Obstet Gynecol, 2004, 190(2): 502-505. 引證本文：GAO F, QI XS, HOU Y, et al. Association between pancreatitis and fatty liver disease [J]. J Clin Hepatol, 2017, 33(1): 40-45. (in Chinese) 高帆， 祁興順， 侯悅， 等. 胰腺炎與脂肪肝的關(guān)系探討[J]. 臨床肝膽病雜志, 2017, 33(1): 40-45.

(本文編輯：葛 俊)

Association between pancreatitis and fatty liver disease

GAOFan,QIXingshun,HOUYue,etal.

(MedicalDepartment, 202HospitalofPLA,Shenyang110003,China)

Pancreatitis is a common digestive disease with a high mortality rate. Clinical physicians often encounter patients with pancreatitis and fatty liver disease. This article investigates the association between pancreatitis and fatty liver disease from the aspects of the prevalence of fatty liver disease in patients with pancreatitis, the influence of fatty liver disease on the prognosis of pancreatitis, and pancreatitis induced by acute fatty liver disease during pregnancy.

pancreatitis； fatty liver； prognosis

10.3969/j.issn.1001-5256.2017.01.008

2016-10-11；

2016-11-19。作者簡介：高帆(1982-)，女，主要從事內(nèi)科診療研究。

祁興順，電子信箱：xingshunqi@126.com；郭曉鐘，電子信箱：guoxiaozhong1962@126.com。

R576； R575.5

A

1001-5256(2017)01-0040-06