两种糖分子探针用于测定重症胰腺炎时肠通透性的改变

An experimental study on the two surgery probes for measuring changes of intestinal permeability in acute necrotizing pancreatitis

目的:观察甘露醇和乳果糖用于测定重症胰腺炎时肠通透性的改变.方法:杂种犬15条,随机分为对照组和实验性急性坏死性胰腺炎(ANP)组.发病后给犬灌服甘露醇和乳果糖混合液,收集6小时尿,气相色谱法测定其含量,并作脏器细菌培养.结果:胰腺炎组尿中乳果糖/甘露醇(L/M)比值高出对照组2～12倍,于发病后第2天最为显著.所有动物都出现了肠道细菌移位,血培养阳性率为100%,以发病后48小时内最高.对照组只有2条犬在肠系膜淋巴结培养出细菌.血培养全部阴性.结论:ANP发病后48小时内肠粘膜屏障即遭到严重破坏,发生肠道细菌移位,成为胰腺感染的来源.

Fifteen dogs were divided into control group and acute necrotizing pancreatitis (ANP) group. All dogs were fed with lactose (10g) and mannitol (5g) in 100 ml distilled water on day 1,2,4 and 7,respectively, with urine being collected during the following 6h interim. Gas chromatography was applied to determine the level of lactose and mannitol in the urine. Blood samples were cultured everyday. All animals were sacrificed on day 7. Tissues of organs were collected for microbiological study. The results showed that in ANP group, the levels of lactose were increaeed significantly (P<0.01), and L/M (lactose/mannitol) ratio was 2-12 times of that in the control group, with the peak appearing on day 2. Bacterial translocation(BT) to organs and blood could be found in all animals of ANP group. In control group, blood and tissue culturing were negative except for 2 episodes of BT to mesenteric lymph nodes. The results suggested that injury in the intestinal mucosa might take place soon after the onset of ANP, which led to BT from intestine as the source of pancreatic infection.