大鼠急性坏死型胰腺炎病理特征评定方法的研究

目的　以大鼠胆源性胰腺炎模型为对象 ,比较国外相关的评分标准 ,探讨这一实验模型合理、准确的病理学评定方法。方法　 4 8只SD大鼠分善宁 (16只 )、对照 (2 1只 )和假手术 (11只 )不同处理组 ,胰胆管内注射牛磺胆酸钠诱发大鼠急性坏死型胰腺炎 ,参照Schmidt等普通病理学评分标准并加以改进 ,结合电镜超微结构观察等 ,评定不同标准的病理组织学评分的准确性。结果　急性坏死型胰腺炎大鼠解剖时见大量红色腹腔渗液 ,最多者达体重的 6 % ;光镜下见胰腺组织明显出血、腺细胞坏死 ;小叶破坏 ,结构紊乱 ,小叶间隔大量红细胞 ;肝脏、心脏、肺和肾脏也出现组织充血、出血等。不同处理组的 4项组织学评分标准显示Schmidt方法不能显示组间出血的严重程度 ,炎症、水肿、坏死 3项过于繁冗。以高倍镜下间隔红细胞数平均值和分级评分比较 ,组间出血显示显著性差异。结论　 1)腹腔大量红色渗液、胰腺组织出血坏死、微血管内微血栓形成和胰外多器官损伤等是这一模型的特征 ;2 )在简化Schmidt评分标准中水肿、坏死、炎症等 3项和出血指标以及间隔红细胞数和分级统计的基础上 ,作者提出新的标准 ,以更为准确合理地评定大鼠急性坏死型胰腺炎的病理组织学特征。

Pathological Characteristics of Acute Necrotizing Pancreatitis in Rats and the Methods of Evaluation

ObjectiveCompared with Schmidt Criterion and the others, the authors studied the characteristics of acute necrotizing pancreatitis (ANP) in the rat model triggered with sodium taurocholate (biliary pancreatitis) in order to develop more precise and reasonable method of pathological evaluation in practice. Methods Forty -eight Sprague -Dawley (SD) rats were assigned into 3 different groups, i.e., treatment (16), ANP (21) and sham -operation (11). Acute necrotizing pancreatitis was triggered with injection of sodium taurocholate via the biliopancreatic duct. Schmidt Criterion was employed after modification for histopathological scoring to make sure the accuracy of different methods in evaluation, combined with transmission electronmicroscope. Results Autopsy of the rats showed large amounts of bloody ascites, the largest, 6% of the body weight. Severe hemorrhage and acinar necrosis, destroyed pancreatic lobules with lots of red blood cells between them were demonstrated under microscope. Inflammation, congestion and hemorrhage were also found in liver, heart, lungs and kidneys. Of the 4 parameters of the Schmidt Criterion, the difference of hemorrhage was not revealed significantly between groups, while the other 3, inflammation, edema and acinar necrosis, too elaborate and troublesome. We used the mean count of the red blood cells between pancreatic lobules or grade scoring and found out the significant difference of pancreatic hemorrhage. Conclusions 1. The bile salt model of acute necrotizing pancreatitis triggered with sodium taurocholate is characterized by large amounts of bloody ascites, severe hemorrhage and acinar necrosis, microthrombi in capillaries in pancreatic tissues, and injuries in multiple extra -pancreas organs; 2. On the basis of modification of 3 parameters in Schmidt criterion, i.e., edema, acinar necrosis and inflammation, and the mean count of red blood cells, we suggested a new criterion for more precise histopathological assessment.