重症急性胰腺炎大鼠肾上腺病理及超微结构变化  

Pathological and Ultrastructural Changes of Adrenal Cortex in Rats with Severe Acute Pancreatitis

作　　者：惠远见[1] 王卫星[1] 徐胜[1] 余佳[1] 张昌威[1] 邓文宏[1] 

机构地区：[1]武汉大学人民医院普通外科,武汉430060

出　　处：《微循环学杂志》2009年第3期9-10,15,73,共4页Chinese Journal of Microcirculation

基　　金：湖北省卫生厅基金资助项目(JX4B18)

摘　　要：目的:观察重症急性胰腺炎(SAP)大鼠肾上腺皮质的病理和超微结构变化。方法:采用5%牛磺胆酸钠逆行胰管注射法建立SAP模型,分别于术后3、12、24h测定血淀粉酶,观察胰腺、肾上腺皮质病理变化,透射电镜观察12h肾上腺皮质束状带细胞超微结构。结果:SAP造模成功后,血淀粉酶、胰腺病理评分进行性升高。3h时肉眼见肾上腺包膜轻度水肿,并逐渐加重,24h最为明显;3h肾上腺组织出现血窦扩张,12h可见肾上腺组织水肿、腺体结构轻度破坏、少量炎性细胞浸润,24h肾上腺皮质部分细胞变性及出血性坏死,腺体结构破坏严重;12hSAP大鼠肾上腺皮质束状带细胞超微结构损伤和分泌功能降低等改变。结论:随着SAP病情进展,肾上腺组织病理及超微结构损害加重。肾上腺功能减退可能与其病理、超微结构损伤有关。Objective:To observe pathological and ultrastructural changes of the adrenal cortex in Rats with severe acute pancreatitis(SAP).Method:SAP models was induced by retrograde injection of 5%sodium taurocholate into the pancreatic duct.At 3,12 and 24 h after operation,serum amylase were measured,pathological changes of pancreas and adrenal gland were obeserved under light microscope,and morphological changes of adrenal gland under naked eyes.Moreover,ultrastructure of adrenal gland were examined by electron microscope at 12 h.Results:In SAP group,Serum amylase and pancreatic pathologic scores rised progressively,envelope of adrenal glands got edematous at 3 h,aggravated gradually and became severest to 24 h.Blood sinusoid of adrenal gland in SAP group dilated at 3 h,adrenal tissue showed edematous at 12 h,with structure damaging mildly and few inflammatory cells infiltrating,to the next time-point some cortex cells suffered degeneration and hemorrhagic necrosis as structure being ruined.Ultrastructure in zona fasciculata cells appeared changes of being injured and reduction of secretion at 12 h.Conclusion:Adrenal zona fasciculata was damaged apparently as pancreatitis aggravating,pathological and ultrastructural changes of the adrenal cortex is a potent predictor of adrenal insufficiency.

关 键 词：肾上腺功能不全 重症急性胰腺炎 超微结构变化 病理 大鼠 多器官功能不全综合症 全身炎症反应综合症 超微结构改变 

分 类 号：R692.5[医药卫生—泌尿科学] R657.51[医药卫生—外科学]