Berry A R, Millar A M, Taylor T V
Dig Dis Sci. 1982 May;27(5):444-8. doi: 10.1007/BF01295654.
The etiology and pathogenesis of acute necrotizing hemorrhagic pancreatitis remain controversial. Recent work has suggested that an early fall in pancreatic blood flow, causing ischemia, may be the initiating factor. Using an established rat model of hemorrhagic pancreatitis and the fractional indicator distribution technique with 86RbCl, pancreatic blood flow and tissue perfusion have been measured at various times in the condition. Six groups of ten rats were studied: control sham operation and pancreatitis groups were sacrificed at 1, 6, and 24 hr. Pancreatic blood flow (% of cardiac output) and perfusion (blood flow/g tissue) were measured. Blood flow was increased by a maximum of 53% at 1 hr (P less than 0.001) and remained elevated for 24 hr, and perfusion was increased by a maximum of 70% (P less than 0.001) at 1 hr and remained elevated at 6 hr. Pancreatic perfusion declines after 6 hr due to increasing gland edema. The results demonstrate a significant increase in pancreatic blood flow and perfusion in experimentally induced acute pancreatitis, suggesting a primary inflammatory response, and refute the ischemic etiological theory.
急性坏死性出血性胰腺炎的病因和发病机制仍存在争议。最近的研究表明,胰腺血流早期下降导致缺血,可能是起始因素。利用已建立的大鼠出血性胰腺炎模型和用86RbCl的分数指示剂分布技术,在该病症的不同时间测量了胰腺血流和组织灌注。研究了六组,每组十只大鼠:对照组假手术组和胰腺炎组分别在1、6和24小时处死。测量胰腺血流(心输出量的百分比)和灌注(血流/克组织)。血流在1小时时最多增加53%(P小于0.001),并持续升高24小时,灌注在1小时时最多增加70%(P小于0.001),并在6小时时仍保持升高。由于腺体水肿增加,6小时后胰腺灌注下降。结果表明,实验性诱导的急性胰腺炎中胰腺血流和灌注显著增加,提示原发性炎症反应,并反驳了缺血病因理论。