Li Yong Yu, Zhu Guo Ying, Gao Yong Xin, Yang Zhi Yong, Wang Zhu Yi
Department of Pathophysiology, Medical School of Tongji University, Shanghai, China.
Chin J Dig Dis. 2006;7(3):164-9. doi: 10.1111/j.1443-9573.2006.00262.x.
To investigate alterations of the pancreatic endocrine component in the early stage of acute necrotic pancreatitis (ANP) in rats.
Thirty-six Sprague-Dawley rats were randomly allocated to two groups: ANP group (n = 18) and sham-operated (control) group (n = 18). ANP was induced by retrograde injection of 4% sodium deoxycholate (40 mg/kg, 0.1 mL/min) into the biliopancreatic duct and the severity of pancreatitis induced was assessed by histopathological examination and level of plasma amylase. The pancreatic endocrine function was assessed by measuring the levels of plasma glucose and insulin and by measuring the insulin content in pancreatic beta cells by immunofluorescence and immunocytochemistry.
Five hours after operation, the pancreas of rats in the ANP group showed pathological changes with edema, hemorrhage, fatty necrosis, acinar destruction and leukocyte infiltration in the exocrine portion of the pancreas. Plasma amylase activity increased significantly (P < 0.01) and bloody ascites appeared in the abdominal cavity. Nevertheless the endocrine islets appeared normal and the beta cells contained intensive labeling of insulin. Levels of glucose and insulin in plasma increased significantly. In the ANP group, 5 h after operation the plasma level of glucose was 8.18 +/- 2.26 mmol/L vs 6.39 +/- 1.26 mmol/L, and of insulin was 23.27 +/- 3.50 MIU/L vs 18.40 +/- 3.98 MIU/L. In the control group, 5 h after operation the plasma level of glucose was 9.39 +/- 0.62 mmol/L vs 5.89 +/- 0.62 mmol/L, and of insulin was 26.28 +/- 4.77 MIU/L vs 12.89 +/- 2.05 MIU/L; there was no significant difference between these two groups (P > 0.05). After a bolus injection of glucose, however, a much higher level of insulin was found in the control group (35.30 +/- 5.05 MIU/L) than that in the ANP group (23.91 +/- 4.62 MIU/L, P < 0.05).
There may be an impaired ability of insulin release in response to glucose stimulation in the early stage of ANP, although the morphology of the pancreatic endocrine component remains intact.
研究大鼠急性坏死性胰腺炎(ANP)早期胰腺内分泌成分的变化。
将36只Sprague-Dawley大鼠随机分为两组:ANP组(n = 18)和假手术(对照)组(n = 18)。通过向胆胰管逆行注射4%脱氧胆酸钠(40 mg/kg,0.1 mL/min)诱导ANP,并通过组织病理学检查和血浆淀粉酶水平评估诱导的胰腺炎严重程度。通过测量血浆葡萄糖和胰岛素水平以及通过免疫荧光和免疫细胞化学测量胰腺β细胞中的胰岛素含量来评估胰腺内分泌功能。
术后5小时,ANP组大鼠的胰腺出现病理变化,胰腺外分泌部有水肿、出血、脂肪坏死、腺泡破坏和白细胞浸润。血浆淀粉酶活性显著升高(P < 0.01),腹腔出现血性腹水。然而,内分泌胰岛外观正常,β细胞含有密集的胰岛素标记。血浆中葡萄糖和胰岛素水平显著升高。在ANP组中,术后5小时血浆葡萄糖水平为8.18±2.26 mmol/L,而对照组为6.39±1.26 mmol/L;胰岛素水平在ANP组为23.27±3.50 MIU/L,对照组为18.40±3.98 MIU/L。在对照组中,术后5小时血浆葡萄糖水平为9.39±0.62 mmol/L,而术前为5.89±0.62 mmol/L;胰岛素水平为26.28±4.77 MIU/L,术前为12.89±2.05 MIU/L;两组之间无显著差异(P > 0.05)。然而,在静脉注射葡萄糖后,发现对照组的胰岛素水平(35.30±5.05 MIU/L)远高于ANP组(23.91±4.62 MIU/L,P < 0.05)。
ANP早期可能存在胰岛素释放对葡萄糖刺激反应的能力受损,尽管胰腺内分泌成分的形态保持完整。