Widdison A L
Bristol Royal Infirmary.
Ann R Coll Surg Engl. 1996 Jul;78(4):350-3.
John Hunter studied comparative anatomy of the pancreas but was unaware of pancreatic infection which is now the leading cause of mortality in pancreatitis. This was investigated using a feline model of pancreatitis. Pathogens spread to the healthy and inflamed gland from many sources including colon, gallbladder, or a septic focus and by various routes including the circulation, reflux into the pancreatic duct or by transmural migration from the colon. Colonisation risk was proportional to necrosis and inflammation, confirming clinical observations. These studies showed that pathogens frequently colonised the pancreas, but infection developed only in animals with pancreatitis. In cats with pancreatitis, phagocytic function was reduced by 28%. This was probably owing to phagocytic capacity being overwhelmed by protease-antiprotease complexes because, in humans, granulocyte and lymphocyte function was normal. These experiments suggested that it would be difficult to prevent pancreatic colonisation, but indicated some types of therapy may have potential. These were investigated using this animal model of pancreatic infection. Treatment with either cefotaxime or levamisole (an immunostimulant) were effective. However, the anti-inflammatory drug dopamine, which reduced inflammation, did not eradicate all pathogens.
约翰·亨特研究了胰腺的比较解剖学，但当时并不知道胰腺感染，而胰腺感染如今是胰腺炎致死的主要原因。这一情况是通过猫胰腺炎模型进行研究的。病原体从包括结肠、胆囊或感染灶等多个来源，通过包括血液循环、反流至胰管或经结肠透壁迁移等多种途径传播至健康和发炎的腺体。定植风险与坏死和炎症成正比，这证实了临床观察结果。这些研究表明，病原体经常定植于胰腺，但感染仅在患有胰腺炎的动物中发生。在患有胰腺炎的猫中，吞噬功能降低了28%。这可能是由于吞噬能力被蛋白酶 - 抗蛋白酶复合物 overwhelm 了，因为在人类中，粒细胞和淋巴细胞功能是正常的。这些实验表明，预防胰腺定植可能很困难，但指出某些类型的治疗可能具有潜力。使用这种胰腺感染动物模型对这些治疗方法进行了研究。使用头孢噻肟或左旋咪唑（一种免疫刺激剂）进行治疗是有效的。然而，能减轻炎症的抗炎药物多巴胺并不能根除所有病原体。
