急性胰腺炎微循环障碍的发生机制及其治疗进展

Pathogenetic mechanism of microcirculatory disturbance and treatment advances in acute pancreatitis

近年来,越来越多的研究表明,血管收缩、血液分流、灌注不足、血液黏滞度增加以及血液凝固等微循环障碍与急性胰腺炎(AP)的发病机制密切相关。缺血再灌注损伤及氧自由基的不断产生亦可加速AP的进程。介绍了胰腺微循环的解剖学特征、胰腺微循环障碍的病理生理学机制及相关的炎症介质,以及AP微循环障碍的治疗进展,提示胰腺及全身微循环障碍可能在AP发生发展中起着重要的作用。

In recent years, there has been increasing evidence that microcirculatory disturbance, including vasoconstriction, shunting, madequate perfusion, increased blood viscosity, and coagulation, is closely associated with the pathogenesis of acute pancreatitis （AP）. These processes may be exacerbated by ischaemia - reperfusion injury and the generation of oxygen radicals. The anatomical features of pancreatic microcirculation, the pathophysiological mechanism of pancreatic microcirculation disturbance and related inflammatory mediators, and progress in the treatment of mierocirculatory disturbance in AP are reviewed. It is suggested that the pancreatic and systemic microcirculation may play a key role in the development and progression of AP.