肝在重症急性胰腺炎发病过程中的作用

目的 :探讨肝在重症急性胰腺炎发病过程中的作用。　方法 :比较对照组、门腔静脉分流 (PC)组、急性出血坏死性胰腺炎 (ANP)组及PC后立即制作ANP(PC ANP)组大鼠生存时间、血浆和腹水中内毒素、血清和腹水中白细胞介素 6 (IL 6 )及血浆血小板α 颗粒膜蛋白 (GMP 14 0 )水平 ,并对各组动物肺组织进行病理检查。用ANP大鼠腹水经下腔静脉给PC及不分流组进行注射 ,测定血清IL 6水平 ,并与用等渗盐水的对照组进行比较。　结果 :PC后立即制作ANP组生存时间明显减少 ,其血浆内毒素、血清IL 6及血浆GMP 14 0水平明显高于其他各组(P <0 .0 1) ,且其肺组织病变严重。腹水中内毒素、IL 6水平均高于血浆中内毒素、血清IL 6。腹水注射组和PC后腹水注射组血清IL 6水平明显高于对照组和ANP组 ,而前二组之间无明显差异。　结论 :肝在重症急性胰腺炎发病早期对机体起保护作用 ,对ANP腹水进入体循环引起的炎症反应无明显作用。

The role of liver in the process of severe acute pancreatitis

Objectives: To explore the role of liver in the process of severe acute pancreatitis. Methods:Comparing the survival time, the endotoxin level of plasma and ascites , the IL-6 level of serum and ascites, the platelet granule membrane protein-140 (GMP-140) level of plasma and the histology change of lung between control group, portocaval shunting group(PC), acute necrotic pancreatitis (ANP) group and acute necrotic pancreatitis immediately after portocaval shunt(PC ANP) group of rats. Measuring the serum IL-6 of control group, portocaval shunt control group (injecting normal saline through caval vein, PCJ), ascites injecting group (AJ) and ascites injecting portocaval shunt group (PC AJ). Results: The survival time of PC ANP group was much shorter than those of the other groups, and its plasma endotoxin , serum IL-6 and plasma GMP-140 levels were higher than those of the other groups (P<0.01). The histology change of lung in PC ANP group was more severe than those of the other groups. The endotoxin and IL-6 levels of ascites were higher than those of plasma and serum (P<0.01). The levels of serum IL-6 in AJ group and PC AJ group were more than those of control group, PCJ group and ANP group (P<0.05), and there was no obviously difference between AJ group and PC AJ group. Conclusions: Liver plays a protective role in the early stage of ANP.Liver has no obvious effect on inflammatory response by the ascites of ANP already entering into the systematic circulation.