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[大鼠实验性胆固醇结晶微栓塞后急性胰腺炎]

[Acute pancreatitis in the rat following experimental microembolism with cholesterol crystals].

作者信息

Freiburghaus A U, Redha F, Ammann R W, Frick T W

机构信息

Departement Innere Medizin, Universitätspital, Zürich.

出版信息

Helv Chir Acta. 1992 Mar;58(5):611-5.

PMID:1592623
Abstract

Several case reports exist which demonstrate cholesterol crystals to be the cause of acute pancreatitis in humans. The crystals have been found intravascularly in the pancreas and at least in one case the origin of the crystals was known. We have undertaken to experimentally reproduce this pathogenetic mechanism in the rat. 30 rats were subjected to the following procedures: under anaesthesia the splenic artery was distally ligated and proximally cannulated; 16 control animals were injected via the cannula with saline (8 rats), particle free cholesterol saturated physiologic saline (3 rats) or nothing (5 rats). 14 rats were injected with ca. 400 microliters of a dilute suspension of cholesterol crystals of 5-40 microns diameter in cholesterol saturated physiologic saline. The abdomen was closed and after 24 h all animals were killed. Acute pancreatitis was diagnosed in all animals that received cholesterol microcrystals and in none of the controls. The diagnosis was based on macroscopic and histological findings. Acute pancreatitis was of focal, disseminated, necrotic type with oedema and moderate haemorrhage and fat necrosis. Only those parts of the pancreas were affected which were supplied by branches of the distal splenic artery used for retrograde injections of cholesterol crystals. This model supports the notion that microembolic or microthrombotic events play a pivotal role in the pathogenesis of spontaneous acute pancreatitis.

摘要

已有数篇病例报告表明,胆固醇结晶是人类急性胰腺炎的病因。在胰腺内已发现这些结晶存在于血管中,并且至少在一个病例中,结晶的来源是已知的。我们已着手在大鼠身上通过实验再现这种发病机制。30只大鼠接受了以下操作:在麻醉状态下,将脾动脉在远端结扎并在近端插管;16只对照动物通过插管注射生理盐水(8只大鼠)、无颗粒的胆固醇饱和生理盐水(3只大鼠)或不进行注射(5只大鼠)。14只大鼠被注射约400微升直径为5 - 40微米的胆固醇结晶在胆固醇饱和生理盐水中的稀释悬浮液。关闭腹腔,24小时后处死所有动物。所有接受胆固醇微晶注射的动物均被诊断为急性胰腺炎,而对照组无一例发生。诊断基于宏观和组织学检查结果。急性胰腺炎为局灶性、弥漫性、坏死型,伴有水肿、中度出血和脂肪坏死。仅胰腺中由用于逆行注射胆固醇结晶的远端脾动脉分支供血的那些部分受到影响。该模型支持这样一种观点,即微栓塞或微血栓形成事件在自发性急性胰腺炎的发病机制中起关键作用。

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