Hjelmqvist B, Ohlsson K, Aronsen K F
Scand J Gastroenterol Suppl. 1986;126:8-11. doi: 10.3109/00365528609091884.
Pathologic proteolysis in pancreatitis is an important clue to understand the pathophysiology in pancreatitis. Impairment of pancreatic circulation is also important in the development of severe pancreatitis. In an attempt to study some of the biochemical and circulatory events in experimental pancreatitis in the pig the following experiments were undertaken. Pancreatic and splanchnic blood flow were studied in severe and mild pancreatitis with the microsphere method, together with cardiac output and mean arterial pressure. Kininogen, alpha-2-macroglobulin and alpha-1-proteinase inhibitor were measured in plasma and in peritoneal fluid. In severe pancreatitis consumption of kininogen in the peritoneal cavity was demonstrated together with a final lowering of the plasma protease inhibitors. This was accompanied by a rapid reduction of cardiac output and finally mean arterial blood pressure. Pancreatic blood flow was profoundly diminished in this group. No such changes were found in mild pancreatitis. It is concluded that pancreatic ischemia in pancreatitis is associated with protease-antiprotease imbalance.
胰腺炎中的病理性蛋白水解是理解胰腺炎病理生理学的重要线索。胰腺循环受损在重症胰腺炎的发展中也很重要。为了研究猪实验性胰腺炎中的一些生化和循环事件，进行了以下实验。采用微球法研究了重症和轻症胰腺炎时的胰腺和内脏血流，同时测量了心输出量和平均动脉压。测定了血浆和腹腔液中的激肽原、α-2-巨球蛋白和α-1-蛋白酶抑制剂。在重症胰腺炎中，腹腔内激肽原消耗明显，血浆蛋白酶抑制剂最终降低。这伴随着心输出量的迅速减少，最终导致平均动脉血压下降。该组胰腺血流显著减少。轻症胰腺炎未发现此类变化。得出的结论是，胰腺炎中的胰腺缺血与蛋白酶-抗蛋白酶失衡有关。
