胰酶自身消化在大鼠急性出血坏死性胰腺炎病程中的作用

The role of autodigestion of pancreatic enzymes in acute hemorrhagic necrotizing pancreatitis in rats.

目的探讨急性出血坏死性胰腺炎(AHNP)病程中胰酶自身消化对胰腺病变的作用程度及胰酶活性与胰腺病变间的关系。方法以3%牛磺胆酸钠经胆胰管逆行注射制成大鼠AHNP,观察血清、十二指肠液、胰腺组织胰酶活性变化及胰腺组织学改变。结果 AHNP 6小时出现严重的胰腺出血坏死,血清胰酶活性显著升高(P<0.01),十二指肠液、胰腺组织胰酶活性显著降低(P<0.01),12小时后三种胰酶活性呈进行性降低,胰腺组织学改变进行性加重。结论胰酶自身消化是AHNP早期病变的主要原因,血清、十二指肠液及胰腺组织中AMS、LPA、PLA_2活性各呈一致的变化趋势,十二指肠液胰酶活性变化能够反映胰腺的病变程度。

To explore the role of autodigestion of pancreatic enzymes on pancreatic lesions in acute hemorrhagic necrotizing pancreatitis (AHNP), and the relation between the activities of pancreatic enzymes and the pancreatic lesions. Methods The model of AHNP was established by retrograde injection of 3% sodium taurocholate in biliopancreatic duct in rats. The activities of pancreatic enzymes in serum, duodenal juice and pancreatic tissue were determined, and the histological changes of the pancreas were observed. Results At 6 h after AHNP, there were severe hemorrhage and necrosis in pancreas, and the activities of pancreatic enzymes in serum were increased significantly (P<0.01), while those in duodenal juice and pancreas decreased significantly (P<0.01). 12 h later, the activities of pancreatic enzymes in serum, duodenal juice and pancreatic tissue were decreased gradually, and the histological lesions were becoming severer. Conclusion The autodigestion of pancreatic enzymes is a main cause for the carly pancreatic lesions. The changes in the activities of AMS, LPA and PLA_2 are unanimous in serum, duodenal juice and pancreas, and the activities of pancreatic enzymes in duodenal juice can represent the degree of pancreatic lesions.