实验性急性胰腺炎对心肌影响的动态观察

目的：探讨大鼠急性胰腺炎（AP）早期血清淀粉酶、心功能以及心肌酶指标的变化，为临床工作提供相关依据。方法：将SD大鼠（35只）随机分为对照组（7只）和实验组（28只），实验组采用十二指肠结扎法复制大鼠急性胰腺炎模型，并依据术后实际情况将大鼠分为术后3h、6h、9h、12h实验组共4组，每组7只。对照组行假手术。观察2组大鼠术后血清淀粉酶（AMY）、心率（R）、平均动脉压（MAP）、心室率（VR）、平均左室内压（LMVP）、乳酸脱氢酶（LDH）、乳酸脱氢酶同工酶-1（LD-1）、a-羟丁酸脱氢酶（HBDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK—MB）、天门冬氨酸氨基转移酶（AST）、碱性磷酸酶（AKP）的动态变化。结果：AP术后12h实验组AMY明显升高，与其余各组相比差异有统计学意义（P〈0．05）；术后9h实验组与12h实验组R、MAP、VR、LMVP均明显低于对照组，差异有统计学意义（P〈0．05）；AP术后12h实验组AST、AKP、LDH均明显升高，与其余各组相比差异有统计学意义（P〈0．05）；AP术后3h实验组CK、CKMB均明显升高，与其余各组相比差异有统计学意义（P〈0．05）；AP术后12h实验组LD-1、HBDH升高，与对照组及9h实验组相比差异有统计学意义（P〈0．05）。对照组心肌组织无炎细胞浸润，间质无水肿；3h实验组心肌间质仅有轻度水肿；6h、9h实验组心肌间质有少量炎细胞浸润，部分心肌细胞溶解、坏死；12h实验组心肌间质出现较多炎细胞浸润，部分心肌间质有出血。结论：十二指肠结扎法所致大鼠急性胰腺炎模型过程中，血清淀粉酶、心肌酶指标和心功能指标基本呈现先增高后降低的趋势，这可能是急性胰腺炎引起心功能不全的原因之一，对其心功能指标和心肌酶指标的测定可早期发现急性胰腺炎所致心功能的损害。

Experiment the dynamic state observation of pancreatitis to the myocardial function influence

Objective: To investigate the alteration of amylase,cardiac function,cardioenzymes in early acute pancreatitis in rats,and the role it plays in the development during the disease and to provide theoretical basis for clinical practice.Methods: Thirty five SD rats were randomly divided into control groups(7) and experimental groups(28).The experimental groups were established acute pancreatitis modle through duodenum ligation then divided these rats into 3 h,6 h,9 h,12 h groups and each group has 7 rats.Observed and measured the levels of AMY,heart R,MAP,VR,LMVP,LDH,LD1,HBDH,CK,CKMB,AST,AKP in plasma and cardiac tissue.Give the control groups shame operation,then take the same observation as the experimental groups.Results: AMY of 12 h group obviously increased after AP operation,compared with other groups(P<0.05);the levels of R,MAP,VR,LMVP were obviously decreased of 9 h and 12 h groups,compared with control group(P<0.05);the levels of CK,CK-MB were obviously increased,compared with rest group(P<0.05),LD-1,HBDH increased,compared with control group and 9 h group(P<0.05).Morphologic observation: myocardium mesenchymal of control group had no edema and no inflammatory cells;myocardium mesenchymal of 3 h experimental group had light edema;there were few of inflammatory cells and part of myocardial cells occurred lysis and necrosis in the 6 h,9 h group;there were more inflammatory cells in 12 h group,part of myocardium mesenchymal had haemorrhage.Conclusion: In the processing of acute pancreatitis by duodenum ligation,amylase,cardiaoenzyme and cardiac function basically show the trend of first increase and then decrease,this may be one of the reasons that lead the cardiac disfunction and may earlier discover the injury of cardiac function by measuring the cardiac function and cardiaoenzymes in acute pancreatitis.