Miyake H, Harada H, Ochi K, Oka H, Ishibashi T, Kimura I
Second Department of Internal Medicine, Okayama University Medical School, Japan.
Pancreas. 1988;3(2):213-9. doi: 10.1097/00006676-198804000-00017.
Human pure pancreatic juice (PPJ) and serum were analyzed for free fatty acids (FFAs) to study whether the damage to pancreatic cell membranes in pancreatitis is reflected as abnormal FFAs concentration and composition. Patients consisted of 13 normal controls, 7 patients with acute pancreatitis (AP) in remission, and 27 with chronic pancreatitis (CP). PPJ was collected at 2-min intervals after secretin and then cholecystokininpancreozymin stimulation by endoscopic cannulation of the pancreas. The following results were obtained: (a) serum FFAs concentration and composition showed no significant difference between the three groups. (b) FFAs concentration in PPJ was significantly raised in CP through all secretory phases. The rise was significant only in "secretin phase" in AP. In many of the cases with raised FFAs concentration in PPJ, the FFAs composition was similar to that in serum. (c) Arachidonic acid, undetected in normal PPJ, was disproportionately high in concentration and composition in PPJ of eight patients with CP. Two mechanisms were proposed to explain these abnormalities: transudation of serum FFAs into the pancreatic duct and local production of arachidonic acid as a result of the damage to pancreatic cell membranes.
对人纯净胰液（PPJ）和血清中的游离脂肪酸（FFA）进行分析，以研究胰腺炎时胰腺细胞膜的损伤是否表现为游离脂肪酸浓度及组成异常。患者包括13名正常对照者、7名急性胰腺炎（AP）缓解期患者和27名慢性胰腺炎（CP）患者。通过内镜下胰腺插管，在注射促胰液素后每隔2分钟收集一次PPJ，随后注射缩胆囊素-胰酶泌素。结果如下：（a）三组之间血清游离脂肪酸浓度及组成无显著差异。（b）慢性胰腺炎患者在整个分泌期PPJ中的游离脂肪酸浓度均显著升高。急性胰腺炎患者仅在“促胰液素期”游离脂肪酸浓度升高显著。在许多PPJ中游离脂肪酸浓度升高的病例中，游离脂肪酸组成与血清相似。（c）正常PPJ中未检测到的花生四烯酸，在8例慢性胰腺炎患者的PPJ中浓度和组成比例过高。提出了两种机制来解释这些异常情况：血清游离脂肪酸渗入胰管以及胰腺细胞膜损伤导致花生四烯酸局部生成。
