Titova G P, Permiakov N K, Penin V A, Emel'ianov S A, Buzenkov S V
Arkh Patol. 1990;52(10):30-6.
Pancreas was studied histologically, histochemically and electron microscopically in 117 autopsy cases and in the experiment (25 dogs and 60 white rats). Morphogenesis of pancreonecrosis proceeds through certain stages. The initial stages of an acute pancreatic edema is characterized by degenerative and necrotic changes of pancreocytes with parapedesis of pancreatic enzymes into the interstitium and a reactive stromal edema. The following stages are distinguished in the progressing phase of pancreonecrosis: hemorrhagic pancreonecrosis when the proteolytic enzymes provoke a colliquation necrosis of the acinar tissue, fibrinoid necrosis of vascular walls and disturbances of the intravascular hemorheology resulting in the enhancement of destructive processes and hemorrhagic inhibition of tissues; fat pancreonecrosis in which lipolytic enzymes lead to the coagulation necrosis of the acinar and fat tissue while a non-completed proteolysis of necrotic tissues stipulates the intensity of the reactive inflammation.
对117例尸检病例以及实验（25只狗和60只白鼠）中的胰腺进行了组织学、组织化学和电子显微镜研究。胰腺坏死的形态发生过程经历某些阶段。急性胰腺水肿的初始阶段以胰腺细胞的变性和坏死变化为特征，伴有胰腺酶通过旁分泌进入间质以及反应性间质水肿。在胰腺坏死的进展阶段可区分出以下阶段：出血性胰腺坏死，此时蛋白水解酶引发腺泡组织的液化坏死、血管壁的纤维蛋白样坏死以及血管内血液流变学紊乱，导致破坏过程加剧和组织出血性抑制；脂肪性胰腺坏死，其中脂解酶导致腺泡和脂肪组织的凝固坏死，而坏死组织的不完全蛋白水解决定了反应性炎症的强度。
