急性坏死性胰腺炎肠通透性及病理改变实验观察

目的观察急性坏死性胰腺炎（ＡＮＰ）犬肠通透性变化及肠粘膜病理改变。方法１５只杂种犬，分为ＡＮＰ组（ｎ＝８）和对照组（ｎ＝７），经主胰管注入牛磺胆酸钠和胰蛋白酶复制ＡＮＰ模型。用气相色谱法检测尿中乳果糖／甘露醇（Ｌ／Ｍ）比值，第７天剖杀，取回肠粘膜作病理观察。结果ＡＮＰ犬尿中Ｌ／Ｍ比值高出对照组２～１０倍。肠粘膜顶端上皮脱落，脱落处有大量细菌侵入，微绒毛部分脱落，面积减少。血浆内毒素水平高出对照组１～２倍，二胺氧化酶活性下降，细菌移位率１００％。结论ＡＮＰ时肠粘膜严重受损，监测尿中Ｌ／Ｍ比值变化可反映早期肠粘膜损伤。

Changes of intestinal permeability and histologies of intestinal mucosa in acute necrotizing pancreatitis in dogs

Objective To observe the changes in intestinal permeability and pathological changes of the intestinal mucosa in acutenecrotizing pancreatitis (ANP). Methods Fifteen dogs were randomly divided into ANP group (n=8) and control group (n=7). ANPmodel was induced by injection of 0.5 ml/kg 5% sodium taurocholate with 3 000 U/kg trypsin into the pancreatic duct. Gaschromatography was applied to determine the levels of lactulose and mannitol in the urine. All the animals were sacrificed on theseventh postoperative day, and the tissue of the lieal mucosa was collected for histological and ultrastructural studies. Results TheL/M (lactulose/mannitol) ratio levels were 2-10 times higher than that of the controls. The epithelial villi of the mucosa exfoliated,the microvilli and the area of the villi was reduced. Diamine oxidase activities were also decreased. Blood levels oflipopolysaccharide are increased 1 -2 times. The translocation rate of bacteria was 100%. Conclusion ANP induced impairment of thegut barrier function, which led to LPS and bacterium translocation; Determining the changes of L/M in the urine can reflect the earlyinjury of intestinal mucosa in ANP.