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牛磺胆酸钠诱导的急性胰腺炎的组织病理学连续变化。

Histopathological sequential changes in sodium taurocholate-induced acute pancreatitis.

作者信息

Kudari Ashwinikumar, Wig Jai Dev, Vaiphei Kim, Kochhar Rakesh, Majumdar Siddarth, Gupta Rajesh, Yadav Thakur Deen, Doley Rudra Prasad

机构信息

Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

JOP. 2007 Sep 7;8(5):564-72.

Abstract

CONTEXT

Experimental models of acute pancreatitis have been developed in order to understand its pathophysiology and extrapancreatic manifestations.

OBJECTIVE

The objective of our study was to study sequential changes in the pancreas and distant organs in sodium taurocholate-induced acute pancreatitis in a rat model.

ANIMALS

Sixteen male Wistar rats weighing 250-300 g.

DESIGN

The rats were distributed into two groups: induced acute pancreatitis (study group: 8 rats) and a control group (8 rats). Within each group, the animals were divided into subgroups: those who were sacrificed early (24 h and 72 h; two each) and those who were sacrificed late (120 h and 240 h; two each).

INTERVENTION

Acute pancreatitis was induced in the rats by multiple intraparenchymal injections of 10% sodium taurocholate solution. In the controls, the same amount of normal saline was injected into the pancreatic parenchyma.

MAIN OUTCOME MEASURES

Pathological examination of the pancreas, lungs, kidneys, intestine and liver was done.

RESULTS

In this model of taurocholate-induced acute pancreatitis, the early changes observed in the pancreas were focal hemorrhages, parenchymal necrosis and neutrophil infiltration. At 72 hours, the changes observed were acinar necrosis, edema, fibrin deposition and inflammatory cell infiltration. Late changes were fibrinoid necrosis and fibroblast proliferation. In the acute phase, the histological changes in the lungs were congestion, focal pulmonary edema and intra-alveolar hemorrhages while, in the late stage, there was persistence of vascular congestion. The changes observed in the kidneys were vacuolization of tubular epithelium in the subcapsular region and areas of hemorrhage in the interstitium. Intestinal changes included degenerative changes in the villous epithelium in the acute phase with normalization of the histology in the late phase.

CONCLUSION

Our findings correlate with the clinical observation of multisystem organ failure in acute pancreatitis. Early changes in these organs suggest that careful observation is mandatory in patients with acute pancreatitis in order to institute supportive treatment.

摘要

背景

为了解急性胰腺炎的病理生理学及胰腺外表现,已建立了急性胰腺炎的实验模型。

目的

本研究的目的是研究牛磺胆酸钠诱导的大鼠急性胰腺炎模型中胰腺及远处器官的序贯变化。

动物

16只体重250 - 300克的雄性Wistar大鼠。

设计

将大鼠分为两组:诱导急性胰腺炎组(研究组:8只大鼠)和对照组(8只大鼠)。每组内,动物又分为早期处死亚组(24小时和72小时;各2只)和晚期处死亚组(120小时和240小时;各2只)。

干预

通过多次实质内注射10%牛磺胆酸钠溶液诱导大鼠急性胰腺炎。对照组则向胰腺实质内注射等量生理盐水。

主要观察指标

对胰腺、肺、肾、肠和肝脏进行病理检查。

结果

在该牛磺胆酸钠诱导的急性胰腺炎模型中,胰腺早期观察到的变化为局灶性出血、实质坏死和中性粒细胞浸润。72小时时,观察到的变化为腺泡坏死、水肿、纤维蛋白沉积和炎症细胞浸润。晚期变化为纤维蛋白样坏死和成纤维细胞增殖。急性期,肺的组织学变化为充血、局灶性肺水肿和肺泡内出血,而晚期则血管充血持续存在。肾脏观察到的变化为被膜下区域肾小管上皮细胞空泡化和间质内出血区域。肠道变化包括急性期绒毛上皮的退行性变化,晚期组织学恢复正常。

结论

我们的研究结果与急性胰腺炎多系统器官衰竭的临床观察结果相关。这些器官的早期变化表明,对急性胰腺炎患者必须进行仔细观察以便实施支持性治疗。

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