CAJ | 학술논문

目的研究不同海拔重症急性胰腺炎(severe acute pancreatitis,SAP)凝血-抗凝血系统的功能紊乱情况,探索高原SAP的发病机制.方法 72只Wistar大鼠随机分为海拔4300米组(H组)、海拔3300米组(M组)及海拔1500米组(L组),每组再随机分为以下亚组:假手术组(N组)、SAP模型6h组(p6h组)、SAP模型12h组(p12 h组)及SAP模型24 h组(p24 h组).采用胰胆管逆行注射5％牛磺胆酸钠建立SAP动物模型.检测各组血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-dimer)、AT-Ⅲ活性和血清淀粉酶(AMY).结果 (1)同一海拔内,与N组相比,P组各时点的胰腺病理评分、AMY、FIB、D-dimer均增高(P＜0.05),PT、APTT、AT-Ⅲ活性均降低(P＜0.05),且随着时间的延长,P组胰腺病理评分、FIB、D-dimer 增加,AT-Ⅲ活性降低(P＜0.05).(2)三个海拔间,P组同一时点随着海拔的增高,其PT、APTT及AT-Ⅲ活性降低,胰腺病理评分、FIB及D-dimer增高,但是H组的胰腺病理评分、PT、APTT与M组相比差异无统计学意义(P＞0.05);P组同一时点三个海拔的AMY差异无统计学意义(P＞0.05).(3)同一海拔内,P组胰腺病理评分、FIB、D-dimer之间呈正相关(P＜0.05),AT-Ⅲ与胰腺病理评分、FIB、D-dimer呈负相关(P＜0.05).结论高原地区SAP大鼠胰腺病理损伤及凝血-抗凝血系统功能紊乱更为严重,凝血-抗凝功能紊乱为SAP加重因素之一.
목적 연구불동해발중증급성이선염(severe acute pancreatitis,SAP)응혈-항응혈계통적공능문란정황,탐색고원SAP적발병궤제.방법 72지Wistar대서수궤분위해발4300미조(H조)、해발3300미조(M조)급해발1500미조(L조),매조재수궤분위이하아조:가수술조(N조)、SAP모형6h조(p6h조)、SAP모형12h조(p12 h조)급SAP모형24 h조(p24 h조).채용이담관역행주사5％우광담산납건립SAP동물모형.검측각조혈장응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원(FIB)、D-이취체(D-dimer)、AT-Ⅲ활성화혈청정분매(AMY).결과 (1)동일해발내,여N조상비,P조각시점적이선병리평분、AMY、FIB、D-dimer균증고(P＜0.05),PT、APTT、AT-Ⅲ활성균강저(P＜0.05),차수착시간적연장,P조이선병리평분、FIB、D-dimer 증가,AT-Ⅲ활성강저(P＜0.05).(2)삼개해발간,P조동일시점수착해발적증고,기PT、APTT급AT-Ⅲ활성강저,이선병리평분、FIB급D-dimer증고,단시H조적이선병리평분、PT、APTT여M조상비차이무통계학의의(P＞0.05);P조동일시점삼개해발적AMY차이무통계학의의(P＞0.05).(3)동일해발내,P조이선병리평분、FIB、D-dimer지간정정상관(P＜0.05),AT-Ⅲ여이선병리평분、FIB、D-dimer정부상관(P＜0.05).결론 고원지구SAP대서이선병리손상급응혈-항응혈계통공능문란경위엄중,응혈-항응공능문란위SAP가중인소지일.
Objective To investigate the alterations of blood coagulation and fibrinolysis system in murine experimental severe acute pancreatitis (SAP) at different altitudes.Methods 72 Wistar male rats were divided into three groups randomly (n =24 in each group):4300 metres' altitude(group H),3300metres' altitude group(group M) and 1500 metres' altitude group(group L).Each group was further divided into four subgroups (n =6 in each subgroup):normal group (group N),6 hour after SAP model establishment group(group p6 h),12 hour after SAP model group(group p12 h),24 hour after SAP model group(group p24 h).Retrograde pancreatic duct injection of 5％ sodium taurocholate (NaTc) method was used to establish SAP animal model.The levels of amylase (AMY),D-dimer,prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB) and the contents of antithrombin Ⅲ (AT-Ⅲ) in serum were measured.Pancreatic tissues were sampled and studied by hematoxylin-eosin(HE) staining.Results (1)Compared to group N,the pancreas pathology score,AMY,Fib and D-dimer in serum increased significantly (P ＜ 0.05) and PT,APTT and AT-Ⅲ lowered significantly (P ＜ 0.05) at each time point in group P in the same altitude.In group P,the contents of Fib and D-dimer and pathological score gradually increased with time (P ＜ 0.05),AT-Ⅲ activitise gradually decreased with time (P ＜ 0.05) ; there was a significant difference (P ＜ 0.05) when Fib,D-dimer,AT-Ⅲ was compared among three altitude's group P.(2) There was a significant difference (P ＜ 0.05) between histological scores,PT and APTT in group Hp and group Lp,and the same result (P ＜ 0.05) between group Mp and group Lp.There was no significant difference between group Hp and group Mp (P ＞ 0.05).(3) There was a positive correlation between histological scores and Fib,D-dimer (P ＜ 0.05) in group P in the same altitude ; AT-Ⅲ and histological scores,Fib,D-dimer (P ＜ 0.05) have a negative correlation in group P in the same altitude.Conclusions More severe damage of pancreatic tissues and disorders of coagulation and fibrinolysis system were observed in rats with severe acute pancmatitis at high altitudes.Changes in blood coagulation and fibrinolysis system may be involved in the severity of acute pancreatitis.