胰腺微循环的解剖和生理

Anatomy and Physiology of the Pancreatic Microcirculation

目的:揭示胰腺微循环的解剖学特征、动力学特点及相关的机能和临床意义.方法:采用保留动态和组织信息于静态样本的微循环光镜和扫描电镜研究法、FITC红细胞标记胰腺微循环活体荧光显微观察法,对猴、狗、鼠、兔胰腺微循环通道的构筑特征、胰腺活体微循环的动力学特点进行了研究.结果:①胰腺小叶内动脉与小叶内静脉之间包括了胰腺内分泌部和外分泌部两极毛细血管床;②胰腺门脉循环流向是由内分泌部流向外分泌部;③胰腺小叶多由独支的小叶内动脉供血,相邻小叶内动脉及其分支间无吻合存在,属终末动脉;④生理状态下胰腺微循环表现为稳定的毛细血管灌注形式,灌流量约1.18±0.05nl/min;急性胰腺炎早期出现FITC-RBC流量减少、微循环灌流不足和机能毛细血管密度减少.结论:胰腺小叶为胰腺微循环形态与机能的基本单位:胰岛-腺泡门脉循环是胰腺微循环的基本特征;胰腺小叶内动脉具终末动脉的特性,是急性胰腺炎局部微循环紊乱的解剖学基础.

Objective: To study the anatomical and physiological characteristics of pancreatic microcircula-tion and its functional/clinical significance. Methods: Observations were carried out in 30 monkeys, 24 dogs, 62 rats and 24 rabbits by the help of scanning electron microscopy and light microscopy with the technique of retaining microcirculatory dynamic and tissular information in the static specimens, and by intravital fluorecence microscopy with FITC-labeled erythrocytes. Results: (1)There were two capillary beds destined for the endocrine and exocrine parts of pancreas between the intralobular arteriole and venule. (2)The blood of the pancreatic portal circulation flowed from the endocrine to the exocrine part. (3)A single centrally located intralobular artery supplied each pancreatic lobule, there being no anastomosis between the intralobular arterioles or any of their branches, which were end arteries. (4)The physiological blood flow was 1.18±0.05nl/min per capillary with a stable capillary perfusion pattern. Profound decrease in functional capillary density and capillary perfusion were observed in the early phase of acute pancreatitis. Conclusions: Pancreatic lobule is a morphological and functional unit of pancreatic microcirculation. Insulo-acinar portal circulation represents the basic feature of pancreatic microcircula-tion. The intralobular arteriole, being an end artery, forms the anatomical basis of the pancreatic micro-circulatory disturbance during acute pancreatitis.