继发感染致急性坏死性胰腺炎病变加重的动物模型研究

目的 提供继发感染致急性坏死性胰腺炎胰腺坏死病变加重的实验室依据.方法 24只SD大鼠平均随机分成3组:对照组、以逆行胆胰管注射法制备急性坏死性胰腺炎(acute necrotizing pancreatitis,ANP)组与感染性坏死性胰腺炎(infected necrotizing pancreatitis,INP)组.8 h后抽血测定血清淀粉酶、C反应蛋白,并取胰腺组织行光镜、电镜检查和细菌培养.结果 胰腺组织细菌培养阳性率:对照组为0(0/8);ANP组为12.5%(1/8);INP组为100%(8/8).光镜检查结果:对照组未见出血、坏死改变;ANP组可见出血与灶状坏死,中等量炎细胞浸润;INP组出血常见,多见大片状的坏死,大量炎细胞浸润.电镜检查结果:对照组未见异常改变;ANP组可见分泌颗粒增多,粗面内质网轻度扩张;INP组可见分泌颗粒明显增多,粗面内质网扩张明显.ANP组血清淀粉酶、C反应蛋白水平明显升高,而在INP组升高较ANP组更加明显.结论 继发感染确实可导致急性坏死性胰腺炎坏死病变明显加重.

The animal investigation of secondary infection resulting in worsening of acute necrotizing pancreatitis

Objective To provide the laboratory evidence of secondary infection resulting in worsening of acute necrotizing pancreatitis. Methods Twenty-four Sprague Dawley rats were randomly divided into three groups: control group, groups of acute necrotizing pancreatitis(ANP) and infected necrotizing pancreatitis(INP) caused by retrograde injection. Eighth hours after modeled, concentration of amylase and C reactive protein (CRP) in serum were determined; Optical microscope, electronic microscope examination and germ cultivation on pancreatic tissue were carried out after the animals were killed. Results Germ cultivation positive rate of pancreatic tissue: Control group, ANP group and INP group was 0(0/8), 12.5%(1/8), 100%(8/8), respectively.Optical microscope examination of pancreatic tissue: There was no hemorrhage and necrosis in control group; cellular edema, hemorrhage, loci necrosis and moderate quantity of inflammatory cell infiltration were found in ANP group; Cellular edema, hemorrhage frequently, massive and thorough necrosis and a great quantity of inflammatory cell infiltration in INP group. Results of pancreatic tissue were as follow in electronic microscope examination. No pathological change was visible in control group; the quantity of exocrine granules increased, rough endoplasmic reticulum dilated slightly in ANP group; the quantity of exocrine granules increased markedly, rough endoplasmic reticulum dilated strikingly in INP group. The serum levels of amylase and CRP in ANP group were increased, and those in INP group were increased more significantly. Conclusions Secondary infection may result in outstanding worsening of acute pancreatic necrosis.