β-葡萄糖醛酸酶、磷脂酶A_2在急性坏死性胰腺炎及并发感染中作用的研究

The Effects of βglucuronidase and Phospholipase A2 on Acute Necrotizing Pancreatitis in Dogs

为探讨血清β－葡萄糖醛酸酶、磷脂酶Ａ２（ＰＬＡ２）在急性坏死性胰腺炎（ＡＮＰ）及并发感染中的作用。采用杂种犬，通过向主胰管内注入牛磺胆酸钠和胰蛋白酶复制犬ＡＮＰ模型；术后第１，２，４，７天测定血清β－葡萄糖醛酸酶、ＰＬＡ２和胰淀粉酶（ＡＭＹ）活性；每天抽血作细菌培养，第七天处死动物后，脏器作细菌培养。结果显示：ＡＮＰ组犬血清β－葡萄糖醛酸酶、磷脂酶Ａ２水平各时间点均高于对照组１～２倍，ＡＭＹ高出对照组３～８倍；肝、胰、脾、肺、肾及肠系膜淋巴结出现了细菌移位；第１，２天血培养结果分别为６／８和５／８；死亡率为４２．８６％（６／１４）。对照组只有２只犬在肠系膜淋巴结中培养出细菌，脏器和血培养全部阴性。提示：β－葡萄糖醛酸酶、磷脂酶Ａ２在ＡＮＰ病情恶化及并发感染中有重要作用。

To observe the effects of βglucuronidase and phospholipase A2 on acute necrotizing pancreatitis (ANP), we induced the ANP model by injecting sodium taurocholate and trypsin into the pancreatic duct in dogs. The levels of βglucuronidase, phospholipase A2 and amylase were examined on the first, second, fourth and seventh days postoperatively. Blood sample was cultured on every postoperative day. All animals were sacrificed on the seventh postoperative day and the organs were harvested to culture. The results showed that the levels of serum βglucuronidase、phospholipase A2 and amylase in ANP group on days 1,2,4,7 were markedly higher than those in the control group respectively (P<0.01 or P<0.05). In ANP group, blood culture was positive in 6/8 on the first day and 5/8 on the second day. Bacterial translocation was found in liver, pancreas, kidney, lung, spleen and mesenteric lymph nodes in all animals. The death rate was 42.86% in the ANP group. The results suggest that βglucuronidase and phospholipase A2 play important roles in accelerating the disease and secondary infection in ANP.