目的:探讨甲硝唑相关急性胰腺炎的临床特征。方法:检索PubMed数据库截至2019年9月收录的文献，收集文献中甲硝唑与急性胰腺炎因果关系明确、临床资料相对完整的病例，并提取患者以下信息：国籍、性别、年龄、原发病、合并疾病、甲硝唑用药情况、联合用药情况、急性胰腺炎发生情况（发生时间、症状、主要实验室和胰腺影像学检查结果等）、临床处理及转归。对收集到的数据进行描述性统计分析。结果:共收集到患者12例，美国8例，希腊、法国、爱尔兰和土耳其各1例；男性3例，女性9例；年龄22~63岁；原发病为阴道炎者5例，为克罗恩病、吸入性肺炎、溃疡性结肠炎、伪膜结肠炎、牙周脓肿、溃疡性结肠炎合并艰难梭菌结肠炎、艰难梭菌结肠炎者各1例；有消化性溃疡既往史者1例。12例患者共发生甲硝唑相关急性胰腺炎24例次（发生1、2、3、4次者分别为4、5、2、1例），口服用药23例次，静脉用药1例次；单用甲硝唑16例次，联用其他药物8例次。12例患者首次应用甲硝唑至发生急性胰腺炎的时间为（3.9±2.8）d，其中8例患者再次应用甲硝唑至再次发生急性胰腺炎的时间为（3.0±2.5）d，范围均为12 h~8 d。甲硝唑相关急性胰腺炎的临床症状和实验室、影像学检查结果与其他药物引起的急性胰腺炎类似。12例患者出现的24例次急性胰腺炎中，临床表现为腹痛者24例次，恶心21例次，呕吐20例次。诊断急性胰腺炎后均停用甲硝唑，17例次有治疗措施描述，其中11例次给予禁食、镇痛、止吐等对症支持治疗。停用甲硝唑后2~22 d，12例患者急性胰腺炎均痊愈。结论:甲硝唑相关急性胰腺炎多发生在用药8 d内，主要症状为腹痛，可出现恶心、呕吐等前驱症状。早期诊断、及时停药，一般预后较好。“,”Objective:To explore the clinical features of metronidazole-related acute pancreatitis.Methods:Literature included in PubMed database up to September 2019 were searched and cases with a clear causal relationship between metronidazole and acute pancreatitis and relatively complete clinical data were collected. The following information of patients including nationality, gender, age, primary diseases, comorbidity, metronidazole medication, combined medication, occurrence of acute pancreatitis (time from medication to the onset of acute pancreatitis, symptoms, major laboratory tests results, pancreatic imaging findings, and etc.), and clinical treatments and outcomes was extracted. The collected data was analyzed by descriptive statistical method.Results:A total of 12 patients were entered, including 8 from the Unite States, 4 from Greece, France, Ireland, and Turkey, respectively; 3 were males and 9 were females, aged from 22 to 63 years. The primary diseases in 5 patients were vaginitis and in 7 patients were Crohn disease, aspiration pneumonia, ulcerative colitis, pseudomembranous colitis, periodontal abscess, and ulcerative colitis combined with n Clostridium difficile colitis, and n Clostridium difficile colitis, respectively; 1 of them were accompanied by history of peptic ulcer. A total of 24 times of metronidazole-related acute pancreatitis occurred in 12 patients (1, 2, 3, and 4 times occurred in 4, 5, 2, and 1 patients, respectively); 23 of them occurred in oral medication and 1 in intravenous medication; 16 cases occurred when metronidazole was used alone and 8 when metronidazole was in combination with other drugs. Time from the first application of metronidazole to the onset of acute pancreatitis was (3.9±2.8) days in 12 patients, time from reapplying metronidazole to recurrence of acute pancreatitis in 8 patients was (3.0±2.5) days, and the range of occurrence time both were 12 hours to 8 days after medication. The clinical symptoms, laboratory tests, and imaging findings of metronidazole-related acute pancreatitis were similar to those caused by other drugs. All the 24 times of acute pancreatitis had clinical symptoms, including 24 times of abdominal pain, 21 times of nausea, and 20 times of vomiting. Metronidazole was discontinued after the diagnosis of acute pancreatitis. Treatment measures were described in 17 times of acute pancreatitis, including symptomatic and supportive treatments such as fasting, analgesia, and antiemesis in 11 times. All patients recovered after 2-22 days of metronidazole withdrawal.n Conclusions:Metronidazole-related acute pancreatitis usually occurred within 8 days of medication and it mainly manifested as abdominal pain. Prodromal symptoms such as nausea and vomiting might occur in some patients. Early diagnosis and timely discontinuation of the drug might be helpful to a better prognosis in general.