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Risk factors associated with biliary pancreatitis in children.

机译：儿童胆源性胰腺炎的危险因素。

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摘要

Little is known about risk factors for biliary pancreatitis in children. We hypothesized that ethnicity, obesity, and elevated pancreatic and hepatic biomarkers distinguish biliary from non-biliary and gallstone- from sludge-induced pancreatitis. We aimed to (1) characterize pediatric cases of biliary pancreatitis, (2) compare biliary with non-biliary cases, (3) examine differences between younger and older children, and (4) study features that distinguish gallstone- from sludge-induced pancreatitis.;We evaluated 76 episodes of biliary pancreatitis from 271 cases of acute pancreatitis in children admitted to Yale-New Haven hospital from 1994 to 2007. Of the 76 cases, 55% had gallstones, 21% had sludge, and 24% had structural defects. Hispanic children had a 2.85 (p=0.01) and 5.59 (p=0.003) higher probability of being diagnosed with biliary pancreatitis than white and black children, respectively. Median serum amylase and lipase in children with biliary pancreatitis were 64% and 49% higher, respectively, compared to other etiologies (p<0.05). In multiple logistic regression, aspartate aminotransferase (AST) was an independent predictor of biliary pancreatitis (OR=6.69, p=0.001). When comparing gallstone- with sludge-induced etiologies, obesity was an independent predictor (38% more prevalent, p<0.01) of gallstone cases.;Hispanic ethnicity was found to be a risk factor and AST a biomarker for biliary pancreatitis over other etiologies. Furthermore, obesity can distinguish gallstone- from sludge-induced pancreatitis. These findings may spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.
机译：关于儿童胆源性胰腺炎的危险因素知之甚少。我们假设种族，肥胖，胰腺和肝生物标志物升高将胆汁与非胆汁以及胆结石与淤泥诱导的胰腺炎区分开。我们的目的是（1）鉴定小儿胆源性胰腺炎病例，（2）比较胆源性和非胆源性病例，（3）检查年龄较大的儿童之间的差异，以及（4）研究区分胆结石和淤泥性胰腺炎的特征1994年至2007年，我们从Yale-New Haven医院收治的271例儿童的急性胰腺炎中评估了76例胆源性胰腺炎。在这76例病例中，有55％的人有胆结石，21％的人有淤泥，24％的人有结构缺陷。西班牙裔儿童被诊断出胆源性胰腺炎的机率分别比白人和黑人儿童高2.85（p = 0.01）和5.59（p = 0.003）。与其他病因相比，胆源性胰腺炎患儿的血清淀粉酶和脂肪酶中位数分别高出64％和49％（p <0.05）。在多项逻辑回归中，天冬氨酸转氨酶（AST）是胆源性胰腺炎的独立预测因子（OR = 6.69，p = 0.001）。在比较胆结石和污泥引起的病因时，肥胖是胆结石病例的独立预测因子（普遍发生率高38％，p <0.01）。与其他病因相比，西班牙裔是胆源性胰腺炎的危险因素，AST是生物标志物。此外，肥胖症可以区分胆结石和淤泥引起的胰腺炎。这些发现可能会刺激前瞻性研究，以确定对胆源性胰腺炎患儿的最佳评估和治疗。

著录项

  • 作者

    Ma, Michael Hong-Tak.;

  • 作者单位

    Yale University.;

  • 授予单位 Yale University.;
  • 学科 Health Sciences Medicine and Surgery.
  • 学位 M.D.
  • 年度 2012
  • 页码 43 p.
  • 总页数 43
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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