腹膜透析对急性重症胰腺炎大鼠胰腺微循环的影响

目的：探讨腹膜透析（PD）对急性重症胰腺炎（ASP）大鼠胰腺微循环的影响。方法：SD大鼠72只随机分为对照组（24只）、ASP组（24只）和ASP加PD组（24只）；观察各组血清血栓素A2／前列腺素（TXA2／6-K．PGF1a）和内皮素（ET—1）水平，以及胰腺血流波幅和胰腺病理变化。结果：ASP组和PD组血清ET-1水平较对照组明显升高；在同时段病例中，ASP组与加PD组比较，后者的水平明显降低；ASP组和加PD组血清TXA2／6-K—PGF1a水平较对照组明显升高：同时段ASP组与加PD组比较，后者的水平明显降低。ASP组胰腺血流波幅明显降低，加PD治疗后波幅有显著提高。加PD组大鼠的胰腺病理损害较ASP组明显减轻。结论：微循环障碍是ASP的重要病理生理基础．早期行PD治疗能有效地改善ASP所致之血微循环障碍，对胰腺有保护作用。

Impact of peritoneal dialysis on the status in microcirculation of acute severe pancreatitis model

Objective To study the impact of peritoneal dialysis(PD) on the status of microcirculation of acute severe pancreatitis(ASP) model.Methods Using a rat model of acute severe pancreatitis,72 SD rats were randomly divided into 3 groups: control group,ASP group and ASP + PD group.The blood concentration of TXA2,6-K-PGF1a and ET-1 were measured,and the pancreatic blood flow(PBF) was scaled by Doppler ultrasonography.The pathological alterations of the pancreas were also observed in all groups.Results The TXA2,6-K-PGF1a and ET-1 levels in the ASP and ASP+PD groups were significantly higher than that of the control group.Furthermore,compared with the ASP group,the levels of these cytokines were significantly reduced in the ASP+PD group.PBF was reduced in the ASP group,but significantly elevated in the ASP+PD group.The scoring of pancreatic damages in the ASP+PD group was lower than that of the ASP group.Conclusions Microcirculation derangement is the basic patho-physiological change leading to the pancreatic lesion of ASP,the early application of PD could ameliorate the microcirculation and prevent further damage.