急性胰腺炎患者并发MODS的机制探讨

Mechanism of acute pancreatitis complicated with MODS

目的 探讨急性胰腺炎患者并发多器官功能不全综合征 (MODS)的机制 ,为防治MODS提供新的思路。方法 收集急性胰腺炎 (AP)患者 6 3例 ,以是否合并脏器功能障碍分为轻型 (n =39)重型(n =2 4 )两组 ,分别测定外周血内毒素、内毒素结合蛋白、内毒素抑制物、CD14以及PBMC中核因子 κB的活性 ,观察它们与MODS发生的关系。结果 ①本组患者MODS的发生率为 38 1%。②AP患者并发内毒素血症 ,其发生率为 74 6 % ,而且患者血浆内毒素结合蛋白、内毒素受体水平均升高 ,但血浆内毒素抑制物水平却明显降低 (P <0 0 5 )。③重型患者上述指标较轻型患者变化更为显著 (P <0 0 5 )。结论 持续内毒素血症、内毒素增敏系统水平增加、NF

Objective To study the mechanism of acute pancreatitis complicated with MODS,and to provide a new way for preventing and treating MODS.Methods Sixty-three pancreatitis patients were divided into two groups:moderate group,patients without organ dysfunction;and severe group,patients with organ dysfunction.Plasma endotoxin,lipopolysaccaride binding protein(LBP),endotoxin inhibitor,sCD14,and nuclear factor-κB(NF-κB)activity in PBMC were determined.Results The incidence rate of MODS and endotoxemia in both groups were 38.1% and 75.64%,respectively.The levels of LBP and sCD14 was increased,but the level of cndotoxin inhibitor was reduced.The NF-κB activity in PBMC was increased,and was related to the severity.Conclusion Continuous endotoxemia,increasing LBP,sCD14,and NF-κB activation may be involved in the development of MODS in patients with acute pancreatitis.