灵长类胰岛的引流系统与胰腺的门脉循环

The Study of Blood Drainage System of Langerhans Islets in the Primates with Special Reference to the Pancreatic Portal Circulation

目的研究灵长类胰岛引流系统与胰腺门脉循环的功能及临床意义。方法用微血管树脂/墨汁灌注扫描电镜/光镜观察、保留动态及组织信息在静态样本的微循环观察法、微循环图象计算机三维重建法 ,对11例男性尸体及40只猴的胰岛血液循环的引流通道及其功能意义进行了系统研究。结果血液经胰岛的入岛动脉 (胰腺小叶内动脉的分支 )到达胰岛血窦 (胰岛毛细血管球 )再经胰岛的输出血管 (出岛门脉 )引流至不同区域的腺泡毛细血管网 ,构成了不同特点的胰腺门脉循环。研究者根据不同区域门脉循环的特征对其进行了分类及命名 :①连续型胰岛 -腺泡门脉循环 :所有灵长类胰岛都具有这类门脉循环。特点是引流系统管径细、行程短、引流至胰岛周围的腺泡毛细血管区域 ;②聚合型胰岛 -腺泡门脉循环 :为部分胰岛所有 ,特点是引流管径粗、行程长 ,引流至远离胰岛的腺泡毛细血管区域 ;③跨越型胰岛 -腺泡门脉循环 :为部分胰岛所有 ,特点是输出管道越过小叶间隔引流至另一胰腺小叶的腺泡毛细血管区域 ,而这一小叶往往没有胰岛存在。结论灵长类胰岛完善的引流系统构成了胰腺内 -外分泌完整的微循环联系 ,即胰岛 -腺泡门脉循环 ;微循环血液流向由内分泌部流向外分泌部 ,提示了胰腺内分泌激素可能是胰腺外分泌腺泡功能活动不可缺少的?

Objective To study the blood drainage system of Langerhans islets in the primates with special reference to the functional and clinical significance of pancreatic portal circulation . Methods Observations were carried out in 11 human corpora, 40 monkeys by scanning electron microscopy and light microscopy with technique of retaining microcirculatory dynamic and tissular information in the static specimens, and microvascular serial reconstruction. Results Three patterns of islet drainage channels with different features were found in our study, they arose from the sinusoidal capillary glomerulus of islet and continued into different acinar capillary network forming a pancreatic portal circulation. The authors suggest that these patterns might be termed as follows: ① Continuous insulo-acinar portal circulation . All islets possessed these portal vessels, they had capillary size, ran a short distance , and then drained into the peri-islet acinar region. ② Convergent insulo-acinar portal circulation: Some islets possessed one or two, occasionally more, of these portal vessels, which were relatively long and/or thick and drained into acinar region far from the islet in the lobule. ③ Translobular insulo-acinar portal circulation These portal vessels crossed the interlobular septum into an adjacent lobule where sometimes no islet existed, and then drained into the exocrine acinar region. Conclusions Langerhans islets possessed the consummate drainage system which drained into different exocrine acinar regions, suggesting that the release of islet hormones is in some way necessary for exocrine secreting function, and that local microcirculatory disturbance and microvacular impairment of the pancreatic portal circulation would be the morphological basis of pancreatic exocrine pathologic lesion in human diabetes.