Patel A G, Toyama M T, Alvarez C, Nguyen T N, Reber P U, Ashley S W, Reber H A
Department of Surgery, Sepulveda Veterans Administration Medical Center, Los Angeles, California, USA.
Gastroenterology. 1995 Nov;109(5):1639-45. doi: 10.1016/0016-5085(95)90654-1.
BACKGROUND & AIMS: Advanced chronic pancreatitis is associated with a reduction in pancreatic blood flow. To determine the physiological significance of this decrease, pancreatic interstitial pH was measured in a model of obstructive chronic pancreatitis in cats and in patients with chronic pancreatitis.
In cats, pancreatic interstitial pH and blood flow were measured serially under basal conditions and after secretory stimulation as chronic pancreatitis evolved. Basal pancreatic interstitial pH was also measured in patients undergoing an operation for chronic pancreatitis or periampullary cancer (controls).
In normal cats, pancreatic interstitial pH was 7.41 +/- 0.01 and blood flow was 124 mL.min-1.(100 g pancreas-1). With the evolution of chronic pancreatitis, interstitial pH and blood flow progressively decreased to 7.21 +/- 0.04 (P < 0.007) and 75 +/- 11 (P < 0.007), respectively. From 1 to 2 weeks, secretory stimulation reduced pancreatic interstitial pH and blood flow further, but as secretory function was lost, this effect disappeared. In patients with chronic pancreatitis, the interstitial pH was lower (7.02 +/- 0.06) than in controls (7.25 +/- 0.04; P < 0.05).
These observations are consistent with the hypothesis that, in chronic pancreatitis, acidic metabolites associated with pancreatic secretion accumulate within the pancreas, probably because of impaired blood flow.
晚期慢性胰腺炎与胰腺血流减少有关。为确定这种减少的生理意义，我们在猫的梗阻性慢性胰腺炎模型以及慢性胰腺炎患者中测量了胰腺间质pH值。
在猫身上，随着慢性胰腺炎的发展，在基础状态下以及分泌刺激后连续测量胰腺间质pH值和血流。还对接受慢性胰腺炎或壶腹周围癌手术的患者（对照组）测量了基础胰腺间质pH值。
在正常猫中，胰腺间质pH值为7.41±0.01，血流为124 mL·min-1·(100 g胰腺-1)。随着慢性胰腺炎的发展，间质pH值和血流分别逐渐降至7.21±0.04（P<0.007）和75±11（P<0.007）。在1至2周时分泌刺激进一步降低了胰腺间质pH值和血流，但随着分泌功能丧失，这种作用消失。慢性胰腺炎患者的间质pH值低于对照组（7.02±0.06比7.25±0.04；P<0.05）。
这些观察结果与以下假设一致，即在慢性胰腺炎中，与胰腺分泌相关的酸性代谢产物可能由于血流受损而在胰腺内积聚。
