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1、·738·ChineseMedicalJournal2001;114(7):738-742MechanismsofmultipleorgandamagesinacutenecrotizingpancreatitisZHANGQunhua张群华,NIQuanxing倪泉兴,CAIDuan蔡端,ZHANGYanling张延龄,ZHANGNiu张妞andHOULandi侯兰娣Keywords:acutenecrotizingpancreatitis·multipleorgan·damages·treatmentObjectiveTodeterminethe
2、roleofsystemicinflammatoryresponsesyndrome(SIRS)andmultipleorgandysfunctionsyndrome(MODS),andevaluatetheprogressfromSIRStoMODSandthetherapeuticstrategiesforacutenecrotizingpancreatitis(ANP).MethodsRatANPmodelsweremadebyretrogradeinjectionof3.5%sodiumtaurocholate2.5ml/kgintothep
3、ancreaticduct.Seruminterleukin-8(IL-8),interleukin-6(IL-6),interleukin-10(IL-10),tumornecrosisfactor-α(TNFα),amylase,endotoxin,andalbuminwereexamined.Themorphologyandpathologyofthepancreas,liver,lung,kidneyandheartafterANPwereobserved.Finally,TNFαmRNAintheliver,lung,kidneyandhe
4、artafterANPwereobservedbyreversetranscriptase-polymerasechainreactions,andtheefficiencyofsomatostatinandgrowthhormonewerealsoobservedinthisexperiment.ResultsANPledtoremarkableelevationoftheinflammatorymediatorswhichwerepositivelycorrelatedwiththedevelopmentofANPandMODS.Somatost
5、atinandgrowthhormoneinhibitedinflammatorymediatorsandTNFαmRNAoverexpressions,reducedtheriskofMODS,correctedhypoalbuminemia,reversednegativenitrogenbalance,andcontrolledthereductionofcellgroupswithfunctionsandreasonablyintervenedSIRScausedbyANP.ConclusionTNFαmRNAplaysanimportant
6、roleinANPprogression.TheameliorationofANPbycombinationtreatmentwithsomatostatinandgrowthhormoneleadstothereductionofcomplicationsandmarkedincreaseinsurvival.ChinMedJ2001;114(7):738-742Studiesconductedduringrecentyearshaveshownthatpancreatitis(ANP)arehottopicsofresearchincontemp
7、orarysurgery.Ourpreliminaryclinicalstudiesmultipleorgandysfunctionsyndrome(MODS)mayoccurduringtheearlystagesofacutenecrotizingpancreatitissuggestedthatmultipleorgandamagescausedbyANPwere(ANP)andthatexcessiveexpressionofinflammatoryrelatedtotheamplifyingeffectsofbothexogenousand
8、3mediatorssuchascytokinesmaycausethetissuedamageendoge
