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目的探讨急性坏死性胰腺炎大鼠脏器功能障碍及病程演进规律。方法大鼠分为两组,急性坏死性胰腺炎(acute necrosis pancreatitis,ANP)组64只,对照组48只。采用经胰管逆行注射5%牛磺胆酸钠诱导ANP,对照组予胰管内注射生理盐水。分别于模型诱导后3、6、9、12、18、24h(每一时间点各8只大鼠)处死,测定大鼠呼吸、体温、心率、血白细胞、肝肾功能及血气分析,另有16只ANP大鼠观察其24h生存率。结果ANP组24h生存率为75%。ANP组在模型制备后3h体温、心率、血白细胞明显高于对照组(P<0.05),6h血清乳酸脱氢酶水平显著升高(2613vs1822IU/L,P<0.05),9h血清肌酐水平显著升高(27.5vs18.7μmol/L,P<0.05),12h动脉血PaO2显著降低(7.8vs12.5kPa,P<0.05),18h之后各脏器处于衰竭期。对照组无脏器功能障碍表现。ANP组各时间点胰腺病理学评分显著高于对照组。结论在5%牛磺胆酸钠诱导的ANP病程中,3h后出现全身炎症反应综合征,6h出现肝功能障碍,9h后进入多脏器功能障碍期,18h后进入多脏器衰竭期。
Objective To investigate the organ dysfunction and the course of disease progression in rats with acute necrotizing pancreatitis. Methods The rats were divided into two groups: 64 rats in acute necrosis pancreatitis (ANP) group and 48 rats in control group. A retrograde pancreatic duct injection of 5% sodium taurocholate induced ANP, the control group was injected into the pancreatic duct normal saline. The rats were sacrificed at 3, 6, 9, 12, 18 and 24 hours after induction of the model (8 rats at each time point). The respiration, body temperature, heart rate, white blood cells, liver and kidney function and blood gas analysis were measured. 16 ANP rats observed 24h survival rate. Results 24h survival rate of ANP group was 75%. The blood temperature, heart rate and white blood cells in ANP group were significantly higher than those in control group (P <0.05) 3h after model preparation. Serum lactate dehydrogenase level was significantly increased at 6h (2613 vs 1822IU / L, P <0.05) (27.5vs18.7μmol / L, P <0.05). PaO2 was significantly decreased at 12h (7.8 vs 12.5kPa, P <0.05). After 18h, all organs were in failure state. Control group showed no organ dysfunction. The pancreatic pathology score of ANP group at each time point was significantly higher than that of control group. Conclusions Systemic inflammatory response syndrome appears after 3 hours in 5% sodium taurocholate-induced ANP course. Hepatic dysfunction occurs in 6 hours, then in multi-organ dysfunction stage after 9 hours and in multiple organ failure after 18 hours.