胰腺炎的全球流行病学和整体预防。
Global epidemiology and holistic prevention of pancreatitis.
机构信息
School of Medicine, University of Auckland, Auckland, New Zealand.
Division of Gastroenterology & Hepatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
出版信息
Nat Rev Gastroenterol Hepatol. 2019 Mar;16(3):175-184. doi: 10.1038/s41575-018-0087-5.
Knowledge of pancreatitis in the 20th century was shaped predominantly by animal data and clinical trials. Several large general population-based cohort studies and comprehensive systematic literature reviews in the 21st century have had a major effect on our understanding of pancreatitis and its sequelae. This Review provides precise and up-to-date data on the burden of acute pancreatitis, chronic pancreatitis and post-pancreatitis diabetes mellitus. Exocrine pancreatic insufficiency and altered bone metabolism following pancreatitis are also discussed. Furthermore, the article introduces a framework for the holistic prevention of pancreatitis with a view to providing guidance on strategies and intervention objectives at primary, secondary and tertiary levels. Concerted efforts by not only gastroenterologists and surgeons but also primary care physicians, endocrinologists, radiologists, pain specialists, dietitians, epidemiologists and public health specialists will be required to reduce meaningfully the burden of pancreatitis and its sequelae over the ensuing decades.
20 世纪对胰腺炎的认识主要来自于动物数据和临床试验。21 世纪的几项大型基于一般人群的队列研究和全面的系统文献综述对我们理解胰腺炎及其后果产生了重大影响。这篇综述提供了关于急性胰腺炎、慢性胰腺炎和胰腺炎后糖尿病的负担的精确和最新数据。此外，本文还讨论了胰腺炎后的外分泌胰腺功能不全和骨代谢改变。此外，本文还介绍了一个整体预防胰腺炎的框架，旨在为初级、二级和三级预防策略和干预目标提供指导。不仅需要胃肠病学家和外科医生，还需要初级保健医生、内分泌学家、放射科医生、疼痛专家、营养师、流行病学家和公共卫生专家共同努力，才能在未来几十年内显著减轻胰腺炎及其后果的负担。
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