急性坏死性胰腺炎合并糖尿病大鼠早期细菌移位的研究

发布时间：2018-04-13 07:24

本文选题：急性坏死性胰腺炎 + 糖尿病　；参考：《中山大学学报(医学科学版)》2017年03期

【摘要】：【目的】探讨糖尿病(DM)是否影响急性坏死性胰腺炎(ANP)早期细菌移位(BT)情况以及病情进展,以期指导临床早期治疗。【方法】35只Wistar雄性大鼠随机分为4组:DM+ANP组(n=10)为ANP合并DM;DM组(n=10)为DM后仅行开腹手术;ANP组(n=10)为非糖尿病行ANP造模;空白组(SO,n=5)为非糖尿病仅行开腹手术。糖尿病成模7 d后行ANP造模或开腹手术,12 h后,取门静脉血、肠系膜淋巴结、胰腺、肝脏等行细菌培养与鉴定并计算细菌移位率;检测门静脉血淀粉酶以及内毒素;观察胰腺、回肠病理损伤程度。【结果】DM+ANP与ANP组死亡率为30%和10%。DM+ANP组与ANP组细菌总移位率分别为23/28(82.1%)、16/36(44.4%),P=0.002,革兰氏阳性菌分别为17/23(73.9%)、3/16(18.8%),P=0.001。ANP组淀粉酶(2302±346)U/L较其他3组明显升高(P=0.000),而DM+ANP组(501±142)U/L未升高,与SO组存在明显差异(P=0.001)。内毒素以及胰腺、回肠病理改变程度方面,DM+ANP组较ANP组、DM组、SO组明显改变(P0.05)。【结论】急性坏死性胰腺炎合并糖尿病早期移位细菌主要为革兰氏阳性菌。糖尿病加重急性坏死性胰腺炎病情、早期细菌移位、内毒素血症以及胰腺回肠损伤。
[Abstract]:[objective] to investigate whether DM affects the early bacterial translocation and progression of acute necrotizing pancreatitis (ANPs).The bacterial culture and identification of portal vein blood, mesenteric lymph nodes, pancreas and liver were performed after 7 days of ANP modeling or laparotomy, and the bacterial translocation rate was calculated, and the portal vein blood amylase and endotoxin were detected, and the pancreas was observed.There was a significant difference between the two groups.Endotoxin and pathological changes of pancreas and ileum in DM ANP group were significantly different from those in ANP DM group. [conclusion] Gram-positive bacteria were the main translocation bacteria in early stage of acute necrotizing pancreatitis with diabetes mellitus.Diabetes exacerbates acute necrotizing pancreatitis, early bacterial translocation, endotoxemia, and pancreatic ileal injury.
【作者单位】：中山大学附属第五医院普通外科;
【基金】：广东省医学科学技术研究基金(B2013156)
【分类号】：R576;R587.1

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