急性出血性坏死性胰腺炎早期实验室诊断的研究

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本实验以犬急性轻型和重型胰腺炎模型为对象,研究重症胰腺炎早期血清学变化。健康杂种犬18只随机分三组。Ⅰ组为对照组,Ⅱ,Ⅲ组分别用1.5%,5%牛磺胆酸钠溶液加压注入犬的主胰管制成犬的轻型和重型胰腺炎模型,手术后1h,4h,7h,12h取静脉血检测淀粉酶,脂肪酶,磷脂酶A2(PLA2)和正铁血红白蛋白(MHA)的含量。结果发现重症组犬血PLA2在术后4h活性明显升高,为轻型组的1.8倍(P<0.01),对照组的4.7倍(P<0.01),且随病程的延长活性逐渐升高。MHA的检测采用双光束二导波紫外分光光度法,血清不需任何处理,敏感性高,1μmol/L以上的含量即可测出。本实验结果表明:重症组犬血MHA含量在术后1h即明显升高17.12±4.61μmol/L,为轻型的4.1倍(P<0.01),对照组的5.3倍(P<0.01),并且发现在术后12h时MHA含量突然增高为轻型组的11.7倍(P<0.01)对照组的39.1倍(P<0.01)。重症组淀粉酶活性仅在1h,4h时与轻型组有显著性差异(P<0.05,P<0.01),而后随病程的延长其活性反而下降。脂肪酶活性升高的较早,术后1h即与轻型组有显著性差别(P<0.0? In this study, acute canine and severe acute pancreatitis model canine for the study of early Serious changes of severe pancreatitis. 18 healthy mongrel dogs were randomly divided into three groups. The rats in group Ⅰ and Ⅱ were injected with 1.5% and 5% sodium taurocholate solution respectively into the canine model of mild and severe pancreatitis. After 1h, 4h, 7h Venous blood samples were taken for detection of amylase, lipase, phospholipase A2 (PLA2) and methemoglobin (MHA) at 12 h. The results showed that the activity of PLA2 in critically ill dogs at 4 hours after operation was significantly higher than that in the mild group (P <0.01), 4.7 times that in the control group (P <0.01) Increased activity of the gradual increase. MHA detection using dual-beam two-guided UV spectrophotometry, serum without any treatment, high sensitivity, 1μmol / L or more content can be measured. The results of this experiment showed that the levels of MHA in critically ill dogs were significantly increased by 17.12 ± 4.61μmol / L at 1 hour after surgery, 4.1 times more than those with mild (P <0.01) and 5.3 (P <0.01), and found that the content of MHA increased suddenly at 12h after operation to 11.7 folds (P <0.01) in the light group and 39.1 folds (P <0.01) in the control group. The activity of amylase in severe group was significantly lower than that in the light group at 1 hour and 4 hours (P <0.05, P <0.01), but decreased with the prolongation of the course. Lipase activity increased earlier, 1h after operation and light group was significantly different (P <0.0?
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