Belokurov Iu N, Utkin A K, Baunov V A
Khirurgiia (Mosk). 1990 Jan(1):52-6.
Operation for pancreonecrosis was carried out in 197 patients, in 52 (26.4%) of them the disease was of alcoholic etiology. The disease was marked by severe clinical manifestations with the development of respiratory, hemodynamic, and peritoneal syndromes and their complications, and by psychic disorders. The endo-intoxication structure was studied in 13 patients by mass-spectrometry proceeding from alcohol metabolism in the organism. Eleven intermediate products were identified: ethanol, acetaldehyde, normal butyraldehyde and isovaleric aldehyde, diethylamine, acetone, isopropanol, methyl isocyanide, trimethylamine, ethannitrile. It was noted that the clinical manifestations of alcoholic pancreonecrosis are included in the spectrum of ethanol pharmacological action; the content of ethanol in the blood was tenfold of the normal, that of the product of its metabolism acetaldehyde was 1.6 times the normal level. Inclusion of exogenic ethanol in metabolism leads to its distortion and accumulation of substances of different origin in the organism, among which an important role is played by acetaldehyde, normal butyraldehyde, and isovaleric aldehyde. The results of the study create proconditions for the search for a rational means for their desactivation.
对197例胰腺坏死患者进行了手术,其中52例(26.4%)病因是酒精性的。该疾病以严重的临床表现为特征,伴有呼吸、血液动力学和腹膜综合征及其并发症的发生,以及精神障碍。根据机体中的酒精代谢情况,通过质谱分析法对13例患者的内毒素结构进行了研究。鉴定出了11种中间产物:乙醇、乙醛、正丁醛和异戊醛、二乙胺、丙酮、异丙醇、甲基异氰化物、三甲胺、乙腈。值得注意的是,酒精性胰腺坏死的临床表现包含在乙醇药理作用范围内;血液中乙醇含量是正常水平的10倍,其代谢产物乙醛的含量是正常水平的1.6倍。外源性乙醇进入代谢会导致其代谢紊乱,并在机体内积累不同来源的物质,其中乙醛、正丁醛和异戊醛起着重要作用。该研究结果为寻找使其失活的合理方法创造了前提条件。