猫胆源性胰腺炎与胰外器官损伤的关系

Correlation between the Type of Acute Pancreatitis and Injuries of Important Organ in Cats

目的 :探讨急性胆源性胰腺炎与胰外器官损伤的关系。 方法 :健康成年杂种猫 36只随机分为 4组 :高压 (2 0kPa)组、低压 (3kPa)组、高压引流组和对照组。采用胆汁与等量 30mmol/L的去氧胆酸钠溶液混合复合液 (称复合液 )逆行胰管内加压注射法 ,制作不同严重程度与急性胆源性胰腺炎动物模型。 18h后观察动物的一般情况 ,腹水的颜色和量 ,血PLA2 、ET - 1、TNF -α等炎症介质水平 ,以及血清淀粉酶和胰腺及心、肝、肺、肾等脏器的组织学变化。 结果 :急性胆源性胰腺炎血清淀粉酶、腹水量、炎性介质含量和胰腺病理评分及心、肝、肺、肾等脏器的组织学变化均明显重于对照组 ,其中高压组又明显重于低压组和引流组。 结论 :胆源性胰腺炎均有心、肝、肺、肾等重要脏器损伤 ,这些胰外重要器官损伤的严重程度与胰腺炎模型的严重程度呈正相关 ;早期胰管减压引流可减轻胰腺炎的严重程度和重要器官损伤。

Objective:To investigate the correlation between the type of acute biliary pancreatitis (ABP)and injuries of important organs Methods:The models of ABP were made with a mixture solution(autologous bile mixed with 30 mmol/L sodium deoxycholate,1:1)being retrogradely injected into the pancreatic duct under different pressure.Thirty six mongrel cats were randomly divided into 4 groups:High pressure group(H,n=10),the injection pressure was 20 kPa for 5 minutes ,then the pancreatic duct was ligated;High pressure with pancreatic duct drainge group(Hd,n=8),except the pancreatic duct drainage,all other procedures were similar to those in the H group;Low pressure group(L,n=10),except for the injection pressure being 3 kPa,all other procedures were similar to those in the H group;Control group(C,n=8):Sham-operation,the pancreas was merely moved a bit.Blood amylase(AMY),inflammatory mediators,the quantity of ascites,and histology of the pancreas,heart,lung,kidneys and liver were observed after the models were made for 18h.Results:The level of blood amylase,inflammmatory mediators(PLA2,ET-1,TNF-α),the quantity of ascites and injuries of the lung,kidneys and liver in the H,Hd and L groups were much higher than in the C group( P< 0 01 or P< 0 05).Those parameters in H group were much higher than those in the L and Hd groups( P< 0 01 ).Conclusion:The injuries of important organs correlate with the type of ABP,early pancreatic duct drainage can abate the severity of the ABP and the injuries of important organs.