急性坏死性胰腺炎肺损伤的发生机制研究

Study on mechanisms of lung injury during acute necrotizing pancreatitis

目的 :研究急性坏死性胰腺炎 (acutenecrotizingpancreatitis ,ANP)早期白细胞粘附强弱和肿瘤坏死因子 (tumornecrosisfactor,TNF)的变化及其与肺损伤的关系 ,探讨ANP肺损伤发生的可能机制。方法 :5只家犬造模后在流室系统下观察白细胞与内皮细胞的粘附强弱 ,并测定血清内毒素水平以及外周血、支气管肺泡灌洗液 (broncho alveolarlavagefluid ,BALF)TNF活性和肺损伤程度 ,与假手术组 (4只 )比较。结果 :模型组犬可见明显肺损伤发生 ;白细胞粘附活性、血清内毒素水平、外周血及BALF中TNF活性明显升高。结论 :白细胞粘附增强和TNF的过度分泌可能是ANP肺损伤发生的机制之一。

Objective:To investigate the changes of leukocyte adhesiveness and tumor necrosis factor(TNF) in the early stage of acute necrotizing pancreatitis(ANP),to go further into the relation of those changes to lung injury of ANP,and to search the probable mechanisms of lung injury during ANP.Methods:After experimental ANP model of 5 canines was made,the adhesion of leukocytes to vascular endothelial cells were observed and measured under flow-chamber system,and endotoxin levels in serum,TNF activities both in serum and in broncho-alveolar lavage fluid(BALF) were measured,and the degrees of lung injury were assessed to compare with those of the sham operation group(n=4).Results:In the experimental model group,significant lung injury were observed,adhesiveness of leukocytes was markedly increased,and endotoxin levels in serum,TNF activities both in serum and in BALF were higher than those in the sham operation group.Conclusion:The increased leukocyte adhesiveness and hypersecretion of TNF is probably one of the mechanisms which take part in the pathogenesis of lung injury in ANP.