辅仁大学基础医学研究所硕士班专题讨论摘要.docVIP

輔仁大學基礎醫學研究所碩士班專題討論摘要 胰臟炎引發肺損傷的可能機制 講員：蔡詩文 日期：1 急性呼吸窘迫症候群是急性胰臟炎併發症中最嚴重的一種，但其中的機制不詳。急性呼吸窘迫症候群通常會發生在急性胰臟炎的早期。臨床上合併肺損傷的急性胰臟炎病患其發病後的七天內有60%的死亡率。急性胰臟炎造成各種蛋白酶釋放到血液中，繼而誘發白血球的活化及發炎前驅物質釋出，進而造成肺損傷。因此，在本研究探討白血球和其中的發炎前驅物質以瞭解胰臟炎與所誘導之肺損傷的關連性。實驗中使用大白鼠(Sprague-Dawley rats)隨機分為三組：1)模擬組2)急性胰臟炎組3)急性胰臟炎並使用蛋白酶抑制劑組。急性胰臟炎的產生是模擬人類因膽結石阻塞膽道所引起的胰臟炎。手術前、後分析血中胰澱粉酶(Amylase)、乳酸脫氫酶(LDH)、白血球、一氧化氮，並於8小時後犧牲動物取肺和胰觀察病理組織切片、溼乾比重(wet/dry ratio)、肺沖洗液總蛋白含量變化。實驗結果發現誘發急性胰臟炎時血中胰澱粉酶、乳酸脫氫酶、一氧化氮、溼乾比重及肺沖洗液總蛋白含量有增加的趨勢，給予蛋白酶抑制劑後產生部分的保護作用。 參考文獻： Balkan, M. Balkan, M. Yasar, A. Korkmaz, O. Erdem,S. Kiilic, O. Kutsal, H. Bilgic. Pulmonary Protective Effects of Hyberbaric Oxygen and N-Acetylcysteine Treatment in Necrotizing Pancreatitis. Physiological Research 2006; 55: 25-31. Wei Sun, Yasuhiro Watanabe, Zhong-Qiu Wang. Expression and significance of ICAM-1 and its counter receptors LFA-1 and Mac-1 in experimental acute pancreatitis of rats. World Journal of Gastroenterology. 2006;12(31):5005-5009. Sugita H, Yamaguchi Y, Ikei S, Yamada S, Ogawa M. Enhanced expression of cytokine-induced neutrophil chemoattractant (CINC) by bronchoalveolar macrophages in cerulein-induced pancreatitis rats. Digestive diseases and sciences. 1997;42(1):154-60 Graduate Institute of Medicine Seminar The Possible Mechanisms Involved in the Pancreatitis- Induced Lung Injury Speaker：Shih Wen Tsai Date：Nov. 9, 2007 Acute respiratory distress syndrome (ARDS) is the most common and severe complication of acute pancreatitis but the mechanisms involved are not clear yet. ARDS usually occurred in the early stage of acute pancreatitis. The mortality occurred over 60% in acute pancreatitis with ARDS. Acute pancreatitis induced proteases release so that white blood cells activation and proinflammatory mediators release. Activated white blood cell sequestered in the lung tissues and lung injury insuring. The aim of this study was to evaluate the roles of white b