兔感染性胆汁诱导的急性胰腺炎。细菌的作用。

Infected bile-induced acute pancreatitis in rabbits. The role of bacteria.

作者信息

Arendt T, Nizze H, Stüber E, Mönig H, Kloehn S, Fölsch U R

机构信息

Department of Internal Medicine, Christian-Albrechts-University, Kiel, Germany.

出版信息

Int J Pancreatol. 1998 Oct;24(2):111-6. doi: 10.1007/BF02788568.

DOI:10.1007/BF02788568

PMID:9816544

Abstract

CONCLUSIONS

Bacteria species commonly found in bile of patients with choledocholithiasis render human bile toxic to the pancreas. The severity of infected bile-induced acute pancreatitis depends on the bacterial species. Infected bile-induced acute pancreatitis turns into a sterile inflammation within 10 d.

BACKGROUND

Flow of bile into the pancreatic duct was proposed to cause some forms of gallstone pancreatitis. The development of bile-induced acute pancreatitis at physiologic ductal pressure is known to depend on the bacterial infection of bile. In this study, we investigated the effect of a variety of bacteria species commonly found in bile of patients with choledocholithiasis upon the pancreatic toxicity of human bile. The time-course of pancreatic infection in infected bile-induced acute pancreatitis was also analyzed.

METHODS

In rabbits, the pancreatic duct was kept obstructed throughout the experiment. After 24 h, 50 microL of pancreatic juice was obtained from the congested pancreatic duct and replaced with the same quantity of infected human bile. Bile contained bacteria (10(7) microorganisms/microL) of species frequently found in choledochal secretions of patients with gallstone disease. Effects on pancreatic morphology were studied after 48 h. In another experiment, the number of Escherichia coli/mg of pancreatic tissue was determined in a time sequence study following exposure of the rabbit pancreatic duct to 50 microL E. coli-infected bile (10(7) microorganisms/mL) and temporary (12 h) or permanent duct obstruction.

RESULTS

Sterile bile was not harmful to the pancreas. Infected bile caused an interstitial-edematous pancreatitis with occasional acinar necrosis. The severity of acute pancreatitis depended on the bacterial species. Following pancreatic duct exposure to E. coli-infected bile, there was complete clearance of the bacteria from the gland with a concomitant interstitial leukocyte infiltration within a period of 2-10 d.

摘要

结论

胆总管结石患者胆汁中常见的细菌种类可使人类胆汁对胰腺产生毒性。感染性胆汁诱导的急性胰腺炎的严重程度取决于细菌种类。感染性胆汁诱导的急性胰腺炎在10天内会转变为无菌性炎症。

背景

胆汁流入胰管被认为会导致某些形式的胆石性胰腺炎。已知在生理导管压力下胆汁诱导的急性胰腺炎的发生取决于胆汁的细菌感染。在本研究中，我们调查了胆总管结石患者胆汁中常见的多种细菌种类对人类胆汁胰腺毒性的影响。还分析了感染性胆汁诱导的急性胰腺炎中胰腺感染的时间进程。

方法

在兔子身上，整个实验过程中胰管保持阻塞。24小时后，从充血的胰管中获取50微升胰液，并用等量的感染人类胆汁替代。胆汁中含有胆结石疾病患者胆总管分泌物中常见的细菌种类（10⁷个微生物/微升）。48小时后研究对胰腺形态的影响。在另一项实验中，在兔子胰管暴露于50微升大肠杆菌感染的胆汁（10⁷个微生物/毫升）并暂时（12小时）或永久阻塞导管后，按时间顺序研究测定每毫克胰腺组织中大肠杆菌的数量。