Wedgwood K R, Farmer R C, Reber H A
Gastroenterology. 1986 Jan;90(1):32-9. doi: 10.1016/0016-5085(86)90071-5.
Acute edematous pancreatitis was induced in cats by perfusing activated pancreatic enzymes through their pancreatic ducts. The ducts had been made permeable to large molecules by one of two techniques. The cats either received ethanol (2 ml/kg every 8 h) and aspirin (25 mg/kg every 8 h) orally for 48 h or had their pancreatic ducts perfused for 1 h with 7.5 mM glycodeoxycholate. When the same procedure was followed, but using 16,16-dimethyl prostaglandin E2 (dmPGE2) (2 micrograms/kg X h infused intravenously for 1 h before and during ductal perfusion with activated enzymes), hemorrhagic pancreatitis developed instead. To investigate whether an increase in pancreatic blood flow or microvascular permeability (both caused by dmPGE2) was important in this phenomenon, we tested the effects of isoproterenol (which increased blood flow) and histamine (which increased microvascular permeability) in the model. Thus in similar experiments, either isoproterenol (0.3 micrograms/kg . min) or histamine phosphate (2 micrograms/kg . min) was infused instead of dmPGE2. The animals that received histamine also developed hemorrhagic pancreatitis. Those that received isoproterenol did not. These observations suggested that an increase in microvascular permeability in the pancreas converted edematous pancreatitis to hemorrhagic pancreatitis. These findings suggest also that clinical studies using prostaglandins to treat patients with pancreatitis should be approached with caution.
通过向猫的胰管灌注活化的胰酶来诱发急性水肿性胰腺炎。采用两种技术之一使胰管对大分子具有通透性。这些猫要么口服乙醇(每8小时2毫升/千克)和阿司匹林(每8小时25毫克/千克),持续48小时,要么用7.5毫摩尔甘氨脱氧胆酸盐对其胰管灌注1小时。当遵循相同程序,但在灌注活化酶之前和期间静脉内输注16,16 - 二甲基前列腺素E2(dmPGE2)(2微克/千克·小时,持续1小时)时,则会发生出血性胰腺炎。为了研究胰腺血流增加或微血管通透性增加(均由dmPGE2引起)在这一现象中是否重要,我们在该模型中测试了异丙肾上腺素(增加血流)和组胺(增加微血管通透性)的作用。因此,在类似实验中,输注异丙肾上腺素(0.3微克/千克·分钟)或磷酸组胺(2微克/千克·分钟)来替代dmPGE2。接受组胺的动物也发生了出血性胰腺炎。接受异丙肾上腺素的动物则未发生。这些观察结果表明,胰腺微血管通透性增加将水肿性胰腺炎转变为出血性胰腺炎。这些发现还提示,在临床上使用前列腺素治疗胰腺炎患者时应谨慎行事。