Institute of Digestive Surgery and Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Hepatobiliary Pancreat Dis Int. 2010 Jun;9(3):242-7.
Acute pancreatitis is an acute inflammatory process of the pancreas that frequently involves peripancreatic tissues and at times remote organ systems. For a long time, the etiology and pathogenesis of acute pancreatitis has been intensively investigated worldwide, but the pathogenetic theories are controversial. The integrity of the pancreatic duct-acinar system might play an important role in the pathogenesis of this disease.
Web of Science and PubMed databases were searched for published studies (between January 1966 and June 2009) to identify relevant articles using the keywords "acinar hyperstimulation", "pathogenesis", "acute pancreatitis", "pancreatic duct-acinar system", and "pancreatic duct pressure". Most of the relevant articles were reviewed.
From critical reading of the relevant articles, we found that the underlying mechanisms involved in the pathogenesis of acute pancreatitis are still under debate and ill-understood. On the basis of the relevant studies, we propose a hypothesis for the pathogenesis of acute pancreatitis, in which the integrity of the pancreatic duct-acinar system plays an essential role in the onset and progression of various forms of the disease.
In our hypothesis, pancreatic duct obstruction and hyperstimulation of the exocrine pancreas are preconditions for the onset of acute pancreatitis; under the common conditions of pancreatic duct obstruction and acinar hyperstimulation, acute pancreatitis arises and develops. This may be an important common pathophysiological mechanism causing various forms of acute pancreatitis.
急性胰腺炎是一种胰腺的急性炎症过程，常涉及胰周组织，有时也涉及远处的器官系统。长期以来，全世界都在深入研究急性胰腺炎的病因和发病机制，但发病理论仍存在争议。胰导管-腺泡系统的完整性可能在该疾病的发病机制中起重要作用。
在 Web of Science 和 PubMed 数据库中，使用“acinar hyperstimulation”、“pathogenesis”、“acute pancreatitis”、“pancreatic duct-acinar system”和“pancreatic duct pressure”等关键词，搜索了 1966 年 1 月至 2009 年 6 月发表的相关研究，以确定相关文章。对大部分相关文章进行了综述。
通过对相关文章的仔细阅读，我们发现急性胰腺炎发病机制的潜在机制仍存在争议，并且认识不足。基于相关研究，我们提出了一个急性胰腺炎发病机制的假说，其中胰导管-腺泡系统的完整性在各种类型疾病的发病和进展中起着重要作用。
在我们的假说中，胰导管阻塞和外分泌胰腺的过度刺激是急性胰腺炎发病的前提条件；在胰导管阻塞和腺泡过度刺激的共同条件下，急性胰腺炎发生和发展。这可能是导致各种类型急性胰腺炎的一个重要的共同病理生理机制。
