{"title":"肝硬化患者胰腺充血与胰腺外分泌功能有关","authors":"Masahito Kokubu, Yoshiki Imamura, Teru Kumagi, Masashi Hirooka, Yuki Numata, Yusuke Okujima, Sho Ishikawa, Kaori Marui-Sato, Mitsuhito Koizumi, Yoichi Hiasa","doi":"10.1111/hepr.14165","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Portal hypertension resulting from liver cirrhosis (LC) can lead to pancreatic congestion and impaired insulin secretion. Therefore, this prospective study aimed to assess the association between pancreatic congestion and exocrine pancreatic function in patients with LC.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In our clinical study, pancreatic congestion and exocrine pancreatic function were evaluated using shear wave dispersion (SWD) and fecal elastase-1 (FE-1). Additionally, pancreatic acinar cells, venous walls, and fibrosis were assessed in an autopsy study.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The FE-1 levels were lower in the LC group (<i>n</i> = 41) than in the control group (<i>n</i> = 41) (312 ± 89 vs. 442 ± 100 μg/g, <i>p</i> < 0.001). The LC group included six patients (14.6%) with exocrine pancreatic insufficiency, whereas there were none in the control group. Pancreatic SWD values were significantly higher in the LC group than in the control group (14.8 ± 2.3 vs. 10.0 ± 1.28 [m/s]/kHz, <i>p</i> < 0.001). Fecal elastase-1 was significantly negatively correlated with pancreatic SWD (<i>R</i> = −0.55, <i>p</i> < 0.001). As for the autopsy study, the percentage of the trypsin-positive area was significantly lower in the LC group (<i>n</i> = 11) than in the control group (<i>n</i> = 10) (38.1 ± 10.1% vs. 26.5 ± 3.0%, <i>p</i> = 0.0055). The percentage of trypsin-positive area was significantly negatively correlated with the wall thickness of the pancreatic vein (<i>R</i> = −0.76, <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Exocrine pancreatic function was reduced and significantly correlated with pancreatic congestion in patients with LC. Portal hypertension may affect the exocrine pancreatic function.</p>\n </section>\n </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 5","pages":"685-695"},"PeriodicalIF":3.4000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14165","citationCount":"0","resultStr":"{\"title\":\"Pancreatic congestion is associated with exocrine pancreatic function in liver cirrhosis\",\"authors\":\"Masahito Kokubu, Yoshiki Imamura, Teru Kumagi, Masashi Hirooka, Yuki Numata, Yusuke Okujima, Sho Ishikawa, Kaori Marui-Sato, Mitsuhito Koizumi, Yoichi Hiasa\",\"doi\":\"10.1111/hepr.14165\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>Portal hypertension resulting from liver cirrhosis (LC) can lead to pancreatic congestion and impaired insulin secretion. Therefore, this prospective study aimed to assess the association between pancreatic congestion and exocrine pancreatic function in patients with LC.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In our clinical study, pancreatic congestion and exocrine pancreatic function were evaluated using shear wave dispersion (SWD) and fecal elastase-1 (FE-1). Additionally, pancreatic acinar cells, venous walls, and fibrosis were assessed in an autopsy study.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The FE-1 levels were lower in the LC group (<i>n</i> = 41) than in the control group (<i>n</i> = 41) (312 ± 89 vs. 442 ± 100 μg/g, <i>p</i> < 0.001). The LC group included six patients (14.6%) with exocrine pancreatic insufficiency, whereas there were none in the control group. Pancreatic SWD values were significantly higher in the LC group than in the control group (14.8 ± 2.3 vs. 10.0 ± 1.28 [m/s]/kHz, <i>p</i> < 0.001). Fecal elastase-1 was significantly negatively correlated with pancreatic SWD (<i>R</i> = −0.55, <i>p</i> < 0.001). As for the autopsy study, the percentage of the trypsin-positive area was significantly lower in the LC group (<i>n</i> = 11) than in the control group (<i>n</i> = 10) (38.1 ± 10.1% vs. 26.5 ± 3.0%, <i>p</i> = 0.0055). The percentage of trypsin-positive area was significantly negatively correlated with the wall thickness of the pancreatic vein (<i>R</i> = −0.76, <i>p</i> < 0.001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Exocrine pancreatic function was reduced and significantly correlated with pancreatic congestion in patients with LC. Portal hypertension may affect the exocrine pancreatic function.</p>\\n </section>\\n </div>\",\"PeriodicalId\":12987,\"journal\":{\"name\":\"Hepatology Research\",\"volume\":\"55 5\",\"pages\":\"685-695\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-01-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14165\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hepatology Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/hepr.14165\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hepatology Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hepr.14165","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的肝硬化门静脉高压可导致胰腺充血和胰岛素分泌受损。因此，本前瞻性研究旨在评估LC患者胰腺充血与外分泌胰腺功能之间的关系。方法采用横波色散（SWD）和粪便弹性酶-1 （FE-1）评价胰腺充血和外分泌胰腺功能。此外，胰腺腺泡细胞、静脉壁和纤维化在尸检研究中被评估。结果LC组（n = 41） FE-1水平低于对照组（n = 41）(312±89∶442±100 μg/g, p <；0.001)。LC组包括6例（14.6%）外分泌胰腺功能不全患者，而对照组无一例。LC组胰腺SWD值显著高于对照组(14.8±2.3 vs. 10.0±1.28 [m/s]/kHz, p <；0.001)。粪便弹性酶-1与胰腺SWD呈显著负相关(R = - 0.55, p <；0.001)。在尸检研究中，LC组胰蛋白酶阳性区域的百分比（n = 11）明显低于对照组（n = 10）（38.1±10.1% vs. 26.5±3.0%,p = 0.0055）。胰蛋白酶阳性面积百分比与胰静脉壁厚呈显著负相关(R = - 0.76, p <；0.001)。结论LC患者外分泌胰腺功能降低，并与胰腺充血显著相关。门静脉高压可影响胰腺外分泌功能。
Pancreatic congestion is associated with exocrine pancreatic function in liver cirrhosis
Aim
Portal hypertension resulting from liver cirrhosis (LC) can lead to pancreatic congestion and impaired insulin secretion. Therefore, this prospective study aimed to assess the association between pancreatic congestion and exocrine pancreatic function in patients with LC.
Methods
In our clinical study, pancreatic congestion and exocrine pancreatic function were evaluated using shear wave dispersion (SWD) and fecal elastase-1 (FE-1). Additionally, pancreatic acinar cells, venous walls, and fibrosis were assessed in an autopsy study.
Results
The FE-1 levels were lower in the LC group (n = 41) than in the control group (n = 41) (312 ± 89 vs. 442 ± 100 μg/g, p < 0.001). The LC group included six patients (14.6%) with exocrine pancreatic insufficiency, whereas there were none in the control group. Pancreatic SWD values were significantly higher in the LC group than in the control group (14.8 ± 2.3 vs. 10.0 ± 1.28 [m/s]/kHz, p < 0.001). Fecal elastase-1 was significantly negatively correlated with pancreatic SWD (R = −0.55, p < 0.001). As for the autopsy study, the percentage of the trypsin-positive area was significantly lower in the LC group (n = 11) than in the control group (n = 10) (38.1 ± 10.1% vs. 26.5 ± 3.0%, p = 0.0055). The percentage of trypsin-positive area was significantly negatively correlated with the wall thickness of the pancreatic vein (R = −0.76, p < 0.001).
Conclusions
Exocrine pancreatic function was reduced and significantly correlated with pancreatic congestion in patients with LC. Portal hypertension may affect the exocrine pancreatic function.
期刊介绍：
Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.
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