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| 1 | Organ failure associated with severe acute pancreatitis显示文摘AIM: To investigate the relationship between severe acute pancreatitis (SAP) and organ failure.METHODS: Clinical data of 74 cases of SAP from Jan. 1993 to Dec. 2002 were retrospectively reviewed, and the relationship between organ failure and age, gender, etiology,extent of necrosis, infection of necrosis and mortality was analyzed.RESULTS: A total of 47 patients (63.5 %) showed organ failure, 20 patients (27.0 %) multiple organ failure, whereas 27 patients (36.5 %) with dysfunction of a single organ system. Pulmonary failure was the most common organ dysfunction (23.0 %) among single organ failures. There were no significant differences in age, gender and gallstone pancreatitis among patients with or without organ failure (P>0.05). The incidence of organ failure in infected necrosis was not higher compared with sterile necrosis, and patients with increased amount of necrosis did not have an increased prevalence of organ failure (P>0.05). Patients with organ failure had a higher mortality rate compared with those without organ failure (P<0.05). The death of SAP was associated with multiple organ failure (P<0.005), pulmonary failure (P<0.005), cardiovascular dysfunction (P<0.05) and gastrointestinal dysfunction (P<0.05).CONCLUSION: Organ failure is common in patients with SAP, and patients with multiple organ failure and pulmonary failure have a higher mortality rate. Prevention and active treatment of organ failure can improve the outcome of patients with SAP. | Ai-JunZhu Jing-SenShi Xue-JunSun | 2003 | World Journal of Gastroenterology2003，9，11： | 66 |
| 2 | Pancreatic microcirculatory impairment in experimental acute pancreatitis in rats显示文摘AIM: To study the feature of pancreatic microcirculatoryimpairment, especially the initial changes, in caerulein-induced experimental acute pancreatitis (AP).METHODS: The pancreatic microcirculation of caerulein-induced AP model was studied by intravital fluorescencemicroscopy with FITC-labeled erythrocytes (FITC-RBC),scanning electron microscopy of vascular corrosion casts,and light microscopy of Chinese ink-injected/cleared tissues.RESULTS: Animals in caerulein-treated group showedhyperamylemia (× 2), pancreatic oedema, infiltration ofinflammatory cells in pancreas. Constrictions of intralobulararteriolar sphincters, presence of vacuoles in all layers ofsphincter, and gross irregularity in capillary network of aciniwere found in the AP specimens. The decrease of pancreaticcapillary blood flow (0.34±0.10 nl @ min-1 vs0.910.06 nl @rain-1 of control, P<0.001), reduction of functional capillarydensity(277± 13 cm-1 vs349±8 cm-1 of control, P<0.001),and irregular intermittent perfusion were observed incaerulein-induced groups.CONCLUSION: Impairment and constriction of pancreaticintralobular arteriolar sphincter are the initial microcirculatorylesions in the early phase of acute pancreatitis, and play akey role in the pancreatic ischaemia and pancreaticmicrovascular failure in acute pancreatitis. | Zong-Guang Zhou You-Dai Chen Wei Sun Zhong Chen,Ⅲ Department of General Surgery(Gastroenteric Surgery),West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China | 2002 | World Journal of Gastroenterology2002，8，5： | 49 |
| 3 | A mouse model of severe acute pancreatitis induced with caerulein and lipopolysaccharide显示文摘AIM: To establish a non-traumatic, easy to induce and reproducible mouse model of severe acute pancreatitis (SAP)induced with caerulein and lipopolyasccharide (LPS).METHODS: Thirty-two healthy mature NIH female mice were selected and divided at random into four groups (each of 8 mice), i.e., the control group (NS group), the caerulein group (Ch group), the lipopolysaccharide group (LPS group),and the caerulein+LPS group (Cn+LPS group). Mice were injected intraperitoneally with caerulein only, or LPS only,and caerulein and LPS in combination. All the animals were then killed by neck dislocation three hours after the last intraperitoneal injection. The pancreas and exo-pancreatic organs were then carefully removed for microscopic examination. And the pancreatic acinus was further observed under transmission electron microscope (TEM). Pancreatic weight, serum amylase, serum nitric oxide (NO)concentration, superoxide dismutase (SOD) and malondialdehyde (MDA) concentration of the pancreas were assayed respectively.RESULTS: (1) NS animals displayed normal pancreatic structure both in the exocrine and endocrine. In the LPS group, the pancreas was slightly edematous, with the infiltration of a few inflammatory cells and the necrosis of the adjacent fat tissues. All the animals of the Cn group showed distinct signs of a mild edematous pancreatitis characterized by interstitial edema, infiltration of neutrophil and mononuclear cells, but without obvious parenchyma necrosis and hemorrhage. In contrast, the Cn+LPS groupshowed more diffuse focal areas of nonviable pancreatic and hemorrhage as well as systemic organ dysfunction.According to Schmidt's criteria, the pancreatic histologic score showed that there existed significant difference in the Cn+LPS group in the interstitial edema, inflammatory infiltration,parenchyma necrosis and parenchyma homorrhage in comparison with those of the Cn group, LPS group and NS group (P<0.01 or P<0.05). (2) The ultrasturcture of acinar cells was seriously damaged in the Cn+LPS group. Chromatin margination of nuclei was present, the number and volume of vacuoles greatly increased. Zymogen granules (ZGs) were greatly decreased in number and endoplasmic reticulum exhibited whorls. The swollen mitochondria appeared, the crista of which was decreased in number or disappeared.(3) Pancreatic weight and serum amylase levels in the Cn +LPS was significantly higher than those of the NS group and the LPS group respectively (P<0.01 or P<0.05).However, the pancreatic wet weight and serum amylase concentration showed no significant difference between the Cn+LPS group and the Cn group. (4) NO concentration in the Cn+LPS group was significantly higher than that of NS group, LPS group and Cn group(P<0.05 or P<0.01). 5) The SOD and MDA concentration of the pancreas in the Cn+LPS group were significantly higher than those of NS, LPS and Cn groups (P<0.05 or P<0.01).CONCLUSION: The mouse model of severe acute pancreatitis could be induced with caerulein and LPS, which could be non-traumatic and easy to induce, reproducible with the same pathological characteristics as those of SAP in human, and could be used in the research on the mechanism of human SAP. | Shi-Ping Ding Ji-Cheng Li Chang Jin Department of Lymphology,Department of Histology and Embryology,Medical College of Zhejiang University,Hangzhou 310031,Zhejiang Province,China | 2003 | World Journal of Gastroenterology2003，9，3： | 33 |
| 4 | 彩色多普勒超声与超声造影诊断急性胰腺炎的对比研究显示文摘目的比较彩色多普勒超声(CDFI)与超声造影(CEUS)对急性胰腺炎(AP)诊断的准确性。方法收集我院2010年5月至2012年5月期间经增强CT(CECT)确诊AP的病例103例(男性64例,女性39例),年龄为(46.3±12.2)岁,均进行CDFI、CEUS(CECT与CEUS检查间隔小于48h)。评估CDFI与CEUS对于AP以及急性重症胰腺炎(SAP)的诊断准确性。结果 103例患者中,急性轻型胰腺炎(MAP)38例,SAP 65例。CDFI诊断AP 86例,诊断准确性83.5%;诊断SAP 32例,诊断准确性49.2%。CEUS诊断AP 97例,诊断准确性94.2%;诊断SAP 62例,诊断准确性95.4%。CEUS对于AP和SAP的诊断准确性高于CDFI(χ2=5.922,P=0.015;χ2=34.574,P=0.00)。结论 CEUS对于AP以及SAP较CDFI具有更高的诊断准确性。 | 蔡迪明 罗燕 李永忠 张琼 王明瑜 夏庆 黄宗文 唐文富 宋彬 | 2014 | 四川大学学报(医学版)2014，45，3： | 10 |
| 5 | 彩色超声与超声造影诊断急性胰腺炎脾静脉并发症的对比研究显示文摘目的探讨急性胰腺炎(acute pancreatitis,AP)发生脾静脉并发症(splenic vein complications,SVCs)时,常规彩色超声(color Doppler flow imaging,CDFI)与超声造影(contrast enhanced ultrasonography,CEUS)对脾脏并发症诊断效能的对比研究。方法收集2012年1月至2013年4月间,我院住院的AP患者144例(男性86例,女性58例),年龄(44.3±11.9)岁,分别进行CDFI、CEUS以及上腹部增强CT(contrast enhanced computer tomography,CECT)检查(CT与超声的检查间隔小于72h)。以CECT结果作为金标准,比较CDFI和CEUS对于诊断AP发生SVCs的诊断效能,对结果进行受试者工作特征曲线(ROC曲线)分析,分别计算CDFI、CEUS各自的曲线下面积(AUC)、敏感性、特异性、准确性、阳性似然比、阴性似然比。结果经CECT证实17例AP发生SVCs,其中CDFI诊断4例,CEUS诊断12例。CDFI的AUC为0.618;CEUS的AUC为0.853。CDFI的敏感性、特异性、准确性、阳性似然比、阴性似然比分别是:17.65%,99.21%,89.58%,22.34,0.83;CEUS的上述参数值为58.82%,98.43%,93.75%,37.46,0.42。CEUS对于SVCs的诊断效能高于CDFI(Z=2.233,P<0.05)。结论 CEUS相较于CDFI,对SVCs诊断更加有效、准确。 | 蔡迪明 罗燕 李永忠 唐文富 黄宗文 宋彬 | 2014 | 四川大学学报(医学版)2014，45，5： | 6 |
| 6 | 胰腺炎脾血管并发症的解剖与诊断进展显示文摘胰腺炎脾血管并发症是较为常见的胰腺炎血管并发症,其发生率虽不高,却是胰腺炎病情重危程度、预后不良的征象之一,如脾动脉假性动脉瘤破裂可危及患者的生命。因此对于胰腺炎脾血管并发症的准确诊断就显得特别重要。超声作为急性胰腺炎检查中最常用的手段,由于易受胃肠道麻痹致腹内胀气、腹膜后血管彩色血流衰减、检查者经验和手法等原因的影响,导致超声对于胰腺炎脾血管并发症的诊断准确率较低。现通过文献复习,对该病的发生、发展以及诊断的进展进行综述,以提高超声医师对该疾病的认识,提高诊断的准确性。 | 蔡迪明 宋彬 | 2015 | 华西医学2015，30，11： | 4 |
| 7 | 急性胰腺炎胰周血管受累的磁共振表现显示文摘目的探讨急性胰腺炎(acute pancreatitis,AP)胰周血管受累的磁共振表现、发生率;胰周血管受累与磁共振严重指数(magnetic resonance severity index,MRSI)的相关性研究。材料与方法收集川北医学院附属医院2009年8月至2013年8月期间326例AP患者资料。所有病例均签署知情同意书。AP患者均在住院后3天内行腹部平扫加增强检查。观察AP的MRI表现,行MRSI评分,观察AP的胰周血管异常表现,用Spearman法统计分析血管并发症与MRSI评分的相关性。结果326例AP患者中,轻度、中度、重度AP患者胰周血管并发症发生率分别为3%(4/124)、17%(31/180)、91%(20/22)。其中脾静脉血栓7例、肠系膜上静脉血栓5例、脾动脉受侵(炎症)47例、脾静脉受侵(炎症)49例,以上血管并发症在MRSI评分轻、中、重度患者中发生率差异具有统计学意义,并与MRSI评分呈正相关(P<0.05,0.30.05,r<0.3)。结论 AP的胰周血管并发症较为常见,脾静脉血栓、脾动静脉炎症、肠系膜上静脉血栓与急性胰腺炎的严重程度呈正相关,可以作为一个早期预测AP严重程度的指标。 | 赵强 张小明 | 2016 | 磁共振成像2016，7，2： | 2 |
| 8 | 超声造影在急性胰腺炎诊疗中的应用进展显示文摘急性胰腺炎(acute pancreatitis,AP)是临床常见的急腹症之一,其病程、临床表现及严重程度高度变化。部分AP 有潜在恶化和致命的结果,因此对于AP 严重程度的分级评估变得至关重要。早期评估和治疗重度感染性坏死病例可明显降低发病率和死亡率。二维超声对于胰腺炎的诊断主要根据胰腺的形态大小、回声的变化和胰周的液体积聚情况,以及难以描绘微小的血管和低速的血流。因此,二维超声对于胰腺炎严重程度的评估有一定的局限性。随着超声造影剂的出现以及超声造影(contrast-enhanced ultrasound,CEUS)技术临床应用的不断深入和超声设备的不断发展,CEUS 在越来越多的疾病中得到应用,其中包括胰腺疾病,特别是AP 的检查,因为CEUS 可显示胰腺实质坏死和坏死程度,明确显示胰外液体聚积情况。本文就CEUS 在AP 中的应用现状及进展做一综述。 | 牛佳美 汪佳旭 熊家伟 杨秀华 | 2019 | 中华医学超声杂志(电子版)2019，16，3： | 2 |
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