急性胰腺炎发病机制研究进展

Advances in the pathogenesis of acute pancreatitis

急性胰腺炎(acute pancreatitis,AP)是一种临床上常见的急腹症,尤其是急性坏死性胰腺炎(acute necrotizing pancreatitis,ANP)由于全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)和多器官功能衰竭(multiple organ failure,MOF)导致病情严重,死亡率高.其发病机制尚未完全阐明且一直为研究焦点.在众多学说中,"胰腺自身消化学说"一直是占主导地位的理论,近年来关于"炎症介质学说"、"肠道细菌易位学说"、"细胞凋亡学说"、"胰腺腺泡内钙超载学说"等也受到了关注和重视.另外,高脂血症尤其是高甘油三酯(TG)血症与AP的关系的研究正逐步深入.本文就AP发病机制的研究进展作一综述.

Acute pancreatitis （AP）, especially acute necrotizing pancreatitis, is a common clinical disorder presenting as an acute abdomen. As AP is often complicated with systemic inflammatory response syndrome and multiple organ failure, the overall mortality rate in AP patients is high. At present, the research on the pathogenesis of AP has attracted wide attention though it has not been fully clarified yet. Of many theories to explain the pathogenesis of AP, ＂the theory of self-digestion of the pancreas＂ is the dominant hypothesis. In recent years, concerns have also been raised over ＂the theory of inflammatory mediators＂, ＂the theory of intestinal bacterial translocation＇＇, ＂the theory of apoptosis＂ and ＂tt^e theory of calcium overload of pancreatic acinar cells＇＇. In addition, extensive research on the relationship between hyperlipidemia, especially high triglycerides （TG）, and AP has also been conducted. In this article, we will review the recent advances in the pathogenesis of AP.