目的探讨急性胰腺炎并发胰性脑病的临床特征和诊断。方法回顾分析28例胰性脑病患者的临床资料并检索收集有关资料。结果重症急性胰腺炎中胰性脑病发生率为67%;胰酶大量吸收入血,并通过血脑屏障造成脑损害是其主要发病机制;脑组织病理检查发现有脱髓鞘现象;大多数患者主要临床表现为一过性精神错乱、意识障碍和神经衰弱等神经精神症状。结论胰性脑病是重症急性胰腺炎严重并发症之一,预后极差;血清髓鞘碱性蛋白升高可望成为胰性脑病的可靠的早期诊断生化指标。甲磺酸加贝酯是一种有效治疗胰性脑病的酶抑制剂。 Objective To investigate the clinical features and diagnosis of acute pancreatitis complicated with pancreatic encephalopathy. Methods The clinical data of 28 patients with pancreatic encephalopathy were retrospectively analyzed and retrieved. Results The incidence of pancreatic encephalopathy in severe acute pancreatitis was 67%. The pancreatic enzymes were absorbed into the bloodstream in a large amount and caused brain damage through the blood-brain barrier. The main pathogenesis was demyelination in brain tissue. Most patients The main clinical manifestations of transient mental disorder, disturbance of consciousness and neurasthenia and other neuropsychiatric symptoms. Conclusions Pancreatic encephalopathy is one of the serious complications of severe acute pancreatitis with poor prognosis. Increasing serum MBP is expected to be a reliable early diagnosis and biochemical indicator of pancreatic encephalopathy. Gabbestefate is an enzyme inhibitor that is effective in the treatment of pancreatic encephalopathy.