[1]莫 闲,杨 闯.急性胰腺炎发病机制及并发内脏静脉血栓研究进展[J].陕西医学杂志,2024,(2):282-285.[doi:DOI:10.3969/j.issn.1000-7377.2024.02.030]
　MO Xian,YANG Chuang.Research progress on pathogenesis of acute pancreatitis and concurrent splanchnic vein thrombosis[J].,2024,(2):282-285.[doi:DOI:10.3969/j.issn.1000-7377.2024.02.030]
点击复制

急性胰腺炎发病机制及并发内脏静脉血栓研究进展
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年2期
页码:
282-285
栏目:
综 述
出版日期:
2024-02-05

文章信息/Info

Title:
Research progress on pathogenesis of acute pancreatitis and concurrent splanchnic vein thrombosis
作者:
莫 闲1; 2; 杨 闯1; 2
(1.川北医学院,四川 南充 637000; 2.四川省精神卫生中心 绵阳市第三人民医院,四川 绵阳 621000)
Author(s):
MO Xian; YANG Chuang
(North Sichuan Medical College,Nanchong 637000,China)
关键词:
急性胰腺炎;  内脏静脉血栓;  钙离子;  胰泡细胞;  炎症;  研究现状
Keywords:
Acute pancreatitis;  Splanchnic vein thrombosis;  Calcium ion;  Pancreatic vacuole cells;  Inflammation;  Research status
分类号:
R 576
DOI:
DOI:10.3969/j.issn.1000-7377.2024.02.030
文献标志码:
A
摘要:
急性胰腺炎(AP)具有进展快、病死率高等特点,其发病因素较为复杂,是临床常见急腹症,临床上依据其器官功能衰竭和并发症发生情况可分为轻度、中度和重度AP。目前有关AP发生机制尚未完全阐明,主要存在胰酶自噬、胰泡细胞凋亡、炎症损伤、钙离子超载等理论。内脏静脉血栓(SVT)是AP常见并发症,其中以脾静脉、门静脉血栓较为常见,SVT可导致AP患者出现胃底静脉大出血、肠缺血坏死等,增加AP患者死亡风险。早期预防SVT发生风险,是改善AP预后的有效手段,临床上常通过药物、液体复苏、营养支持、手术等方法来预防SVT发生。现就其发病机制以及合并SVT进行综述。
Abstract:
Acute pancreatitis(AP)is characterized by rapid progression and high mortality.Its pathogenic factors are complex and it is a common clinical acute abdomen.Clinically,AP can be divided into mild,moderate to severe and severe AP according to its organ failure and complications.At present,the mechanism of AP has not been fully elucidated.There are mainly theories of trypsin autophagy,pancreatic vacuole cell apoptosis,inflammatory injury,calcium overload and so on.Splanchnic vein thrombosis(SVT)is a common complication,among which splenic vein and portal vein thrombosis are more common.SVT can lead to massive gastric fundus hemorrhage and intestinal ischemic necrosis in patients with AP,thus increasing the risk of death in patients with AP.Early prevention is an effective means to improve the prognosis of AP.Clinically,drugs,fluid resuscitation,nutritional support,and surgery are often used to prevent the occurrence of SVT.Now its pathogenesis and merge SVT were reviewed.

参考文献/References:

[1] PENG Y,LI Y,YANG Y,et al.The role and potential regulatory mechanism of STING modulated macrophage apoptosis and differentiation in severe acute pancreatitis-associated lung injury[J].J Interferon Cytokine Res,2023,43(10):455-468.
[2] HOON S L,YOON T L,KOOG Y C.The neutrophil-lymphocyte ratio as an early predictive marker of the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis[J].Medicina,2021,58(1):13-16.
[3] CHAO Y,SONGTAO L,DONGMEI W,et al.Effects of nutritional support combined with insulin therapy on serum proteins,inflammatory factors,pentraxin-3,and serum amylase levels in patients with diabetic ketoacidosis complicated with acute pancreatitis[J].Medicine,2021,100(51):27920-27924.
[4] AALAM S,ARMAAN D,KANWAL B,et al.S113 incidence and clinical predictors of portal vein thrombosis(pvt)in acute pancreatitis:A nationwide analysis[J].The American Journal of Gastroenterology,2022,117(10):82-83.
[5] 赵敏,罗和生.饮食、饮酒、吸烟对急性胰腺炎患者肠道微生物的影响[J].胃肠病学和肝病学杂志,2021,30(7):730-734.
[6] 孟令宽,傅鑫,陈东风,等.重症急性胰腺炎患者PICC静脉置管现状及相关感染与血栓形成的危险因素分析[J].胃肠病学和肝病学杂志,2023,32(1):26-30.
[7] 徐向向,田甜,李雪,等.不同年龄层急性胰腺炎临床特点分析[J].中国临床医生杂志,2020,48(10):1201-1203.
[8] SHEN D,TANG C,ZHU S,et al.Macrophage migration inhibitory factor is an early marker of severe acute pancreatitis based on the revised atlanta classification[J].BMC Gastroenterology,2021,21(1):34-38.
[9] 刁星飞,王志平,冯玉兰.新亚特兰大分类下126例急性胰腺炎CT表现特点及病情严重程度分析[J].中国CT和MRI杂志,2020,18(1):105-107,117.
[10] 崔恬玉,刘瑞霞,阴赪宏.急性胰腺炎胰酶异常活化和分泌的分子机制[J].临床肝胆病杂志,2022,38(5):1198-1202.
[11] JUYEON K,LOREN S,SUNITHA P,et al.Associations between intra-pancreatic fat deposition,pancreas size,and pancreatic enzymes in health and after an attack of acute pancreatitis[J].Obesity Facts,2021,15(1):70-82.
[12] 郑绍越,黄永明,杨正鹏,等.miRNA-383对急性胰腺炎腺泡细胞自噬的影响作用[J].现代生物医学进展,2017,17(1):66-69,99.
[13] 王宝友,潘宏年,王修中,等.microRNA-146a对急性胰腺炎胰腺腺泡细胞增殖及凋亡的影响及其机制研究[J].中国现代医学杂志,2022,32(12):14-19.
[14] CHEHAO L,GUANG X,FAN L,et al.Calcium/P53/Ninjurin 1 signaling mediates plasma membrane rupture of acinar cells in severe acute pancreatitis[J].International Journal of Molecular Sciences,2023,24(14):11554.
[15] 韩宝华,杨文,王慧,等.基于CT评分和炎症因子的重症急性胰腺炎预后模型构建及评价[J].中华危重病急救医学,2023,35(1):82-87.
[16] 吕魁,孙俊峰,杨健鹰.血清C反应蛋白、降钙素原、D-二聚体在急性胰腺炎患者中的表达及与严重程度床边指数和肺损伤的相关性[J].陕西医学杂志,2023,52(10):1375-1378.
[17] 余柠君,刘婷婷,刘超,等.不同炎症活跃程度急性胰腺炎的CT表现特征[J].川北医学院学报,2023,38(4):518-521,570.
[18] 刘伟,支媛,高璐,等.急性胰腺炎患者血清微小RNA-340-3p、CXC趋化因子配体-13和CXC趋化因子配体-16的表达意义[J].陕西医学杂志,2023,52(1):97-100.
[19] 吴红雪,王厚清,燕宪亮,等.重症急性胰腺炎合并脓毒症与病原菌特征、凝血功能及微循环障碍的相关性研究[J].医学研究杂志,2022,51(3):108-112.
[20] 宋杰,银艳桃,王建超,等.血塞通对急性胰腺炎瘀毒互结证患者的炎症、微循环以及肠屏障功能的影响[J].中国中医基础医学杂志,2021,27(8):1289-1294.
[21] CRIDDLE N D.Reactive oxygen species,Ca2+ stores and acute pancreatitis:A step closer to therapy[J].Cell Calcium,2016,60(3):180-189.
[22] 徐晓霞,高静,徐赫一,等.急性胰腺炎血中生长抑素、钙离子及C反应蛋白水平检测及其临床意义[J].内蒙古医科大学学报,2016,38(3):200-204,209.
[23] 王国胜,余玲玲,刘玲玲,等.血清钙离子对急性胰腺炎持续性器官功能衰竭的预测价值[J].世界华人消化杂志,2017,25(23):2117-2122.
[24] 李易晨,柏承文.免疫微生态肠内营养方案可改善重症急性胰腺炎患者肠道菌群和预后[J].内科急危重症杂志,2023,29(1):26-29.
[25] ZHANG X,YANG G,CHEN Y,et al.Resveratrol pre-treatment alleviated caerulein-induced acute pancreatitis in high-fat diet-feeding mice via suppressing the NF-κB proinflammatory signaling and improving the gut microbiota[J].BMC Complementary Medicine and Therapies,2022,22(1):189-193.
[26] TERENCE S,JIMIL S,HARISH B,et al.Deep venous thrombosis in acute pancreatitis is associated with high mortality:A prospective study[J].Digestive Diseases and Sciences,2022,68(3):988-994.
[27] 程家浩,刘正东.重症急性胰腺炎患者ICU期间下肢深静脉血栓形成的发生率和危险因素分析[J].临床急诊杂志,2021,22(9):597-602.
[28] IMAN A,RISHI T,SIMCHA W,et al.Leptospirosis as an unusual culprit of acute pancreatitis and portal vein thrombosis in a New Yorker[J].Clinical Case Reports,2020,8(4):1021-1029.
[29] KUN H,YUELUN Z,KAI S,et al.Randomized controlled trials of low molecular weight heparin in non-mild acute pancreatitis:A systemic review and meta-analysis[J].Thrombosis Research,2023,221(1):26-29.
[30] 黄治家,吕毅.低分子肝素联合前列地尔注射液治疗高脂血症性急性胰腺炎患者的临床研究[J].中国临床药理学杂志,2021,37(21):2870-2874.
[31] 孙会芳.低相对分子质量肝素对重症急性胰腺炎疗效及凝血功能的影响[J].血栓与止血学,2021,27(3):443-444,447.
[32] 黄璟,姜爽.消炎利胆汤联合乌司他丁治疗重症急性胰腺炎肝胆湿热证临床研究[J].陕西中医,2023,44(6):717-720,725.
[33] 王敏,罗小华,卢娟娟.通腑解毒方联合六合丹辅助西医治疗急性胰腺炎临床研究[J].陕西中医,2023,44(4):471-474.
[34] 武鹏宇,刘俊,王琼.不同时点液体复苏治疗对非重症急性胰腺炎患者的疗效[J].贵州医科大学学报,2023,48(2):228-232.
[35] 马军伟,卢启国.急性胰腺炎合并液体积聚患者在经皮穿刺置管引流前行腹腔穿刺引流治疗效果探讨[J].现代消化及介入诊疗,2017,22(1):110-113.
[36] 陈玲,王海林,陈春妙,等.重症急性胰腺炎合并肠系膜上动脉分支假性动脉瘤介入治疗1例[J].温州医科大学学报,2022,52(11):926-927,930.
[37] 尹诗,谢安卫,肖敬鄂,等.二草清胰汤内服及保留灌肠联合乌司他丁治疗急性胰腺炎临床研究[J].陕西中医,2023,44(2):183-186,190.
[38] JUN L,SHU Z,RUI Z,et al.Perspectives of traditional Chinese medicine in pancreas protection for acute pancreatitis[J].World Journal of Gastroenterology,2017,23(20):3615-3623.
[39] 沙盈盈,梁超,朱晓明,等.活血清解汤早期干预对重症急性胰腺炎患者血液流变学及D二聚体、血栓素A-2、前列环素I-2的影响[J].临床肝胆病杂志,2016,32(4):678-681.

相似文献/References:

[1]张玉亮,朱 宏,戴洪山△.B超引导经皮经肝胆囊穿刺引流术在胆源性胰腺炎治疗中的临床意义[J].陕西医学杂志,2019,(2):166.
　ZHANG Yuliang,ZHU Hong,DAI Hongshan..Clinical significance of Bmode ultrasound guided percutaneous transhepatic  gallbladder puncture and drainage in the treatment of biliary pancreatitis[J].,2019,(2):166.
[2]姜 萌,赵 鹏△.奥曲肽联合加贝酯治疗重症急性胰腺炎疗效及对患者血清细胞因子水平的影响[J].陕西医学杂志,2020,49(2):212.
　JIANG Meng,ZHAO Peng..Clinical efficacy of octreotide combined with gabexate in the treatment of severe acute pancreatitis and its effect on serum cytokine levels[J].,2020,49(2):212.
[3]刘 静.红细胞分布宽度联合降钙素原检测对急性胰腺炎严重程度及预后评估价值分析[J].陕西医学杂志,2020,49(4):470.
　LIU Jing..Value of Red cell distribution width combined with procalcitonin in evaluating the severity and prognosis of acute pancreatitis[J].,2020,49(2):470.
[4]朱绍华,何创业,赵 芯.血清微管相关蛋白1轻链3-Ⅱ、半胱氨酸天冬氨酸特异性蛋白酶-3及高迁移率族蛋白B1在不同程度急性胰腺炎中的表达及意义[J].陕西医学杂志,2022,51(9):1098.[doi:DOI:10.3969/j.issn.1000-7377.2022.09.012]
　ZHU Shaohua,HE Chuangye,ZHAO Xin.Expression and significance of serum LC3-Ⅱ,Caspase-3 and HMGB1 in different degrees of acute pancreatitis[J].,2022,51(2):1098.[doi:DOI:10.3969/j.issn.1000-7377.2022.09.012]
[5]刘 伟,支 媛,高 璐,等.急性胰腺炎患者血清微小RNA-340-3p、CXC趋化因子配体-13和CXC趋化因子配体-16的表达意义[J].陕西医学杂志,2023,52(1):97.[doi:DOI:10.3969/j.issn.1000-7377.2023.01.023]
　LIU Wei,ZHI Yuan,GAO Lu,et al.Expressions and significance of miR-340-3p,CXCL-13 and CXCL-16in serum of patients with acute pancreatitis[J].,2023,52(2):97.[doi:DOI:10.3969/j.issn.1000-7377.2023.01.023]
[6]佘育纯,路 勇,王建龙.血清基质金属蛋白酶-9、二胺氧化酶、Toll样受体9与急性胰腺炎患者疾病严重程度及肠黏膜屏障损伤相关性分析[J].陕西医学杂志,2023,52(3):292.[doi:DOI:10.3969/j.issn.1000-7377.2023.03.010]
　SHE Yuchun,LU Yong,WANG Jianlong.Association of serum matrix metalloproteinase-9,diamine oxidase,and Toll-like receptor 9 with disease severity and intestinal mucosal barrier injury in patients with acute pancreatitis[J].,2023,52(2):292.[doi:DOI:10.3969/j.issn.1000-7377.2023.03.010]
[7]吕 魁,孙俊峰,杨健鹰.血清C反应蛋白、降钙素原、D-二聚体在急性胰腺炎患者中的表达及与严重程度床边指数和肺损伤的相关性[J].陕西医学杂志,2023,52(10):1375.[doi:DOI:10.3969/j.issn.1000-7377.2023.10.020]
[8]朱芳丽,马厉英,马晓莹,等.急性胰腺炎患者血清CXC趋化因子配体10和CC类趋化因子22水平与疾病严重程度关系及临床诊断价值研究[J].陕西医学杂志,2024,(6):788.[doi:DOI:10.3969/j.issn.1000-7377.2024.06.014]
　ZHU Fangli,MA Liying,MA Xiaoying,et al.Relationship between serum CXCL10,CCL22 levels and disease severity in patients with acute pancreatitis and their clinical diagnostic value[J].,2024,(2):788.[doi:DOI:10.3969/j.issn.1000-7377.2024.06.014]
[9]赵 跃,徐庆春,杨 洁,等.急性胰腺炎患者血清活化素A、乳酸脱氢酶与白蛋白比值、活化基质金属蛋白酶-8检测及临床意义[J].陕西医学杂志,2025,54(3):399.[doi:DOI:10.3969/j.issn.1000-7377.2025.03.022]
　ZHAO Yue,XU Qingchun,YANG Jie,et al.Serum ACT-A,LAR and aMMP-8 levels in patients with acute pancreatitis and their clinical significance[J].,2025,54(2):399.[doi:DOI:10.3969/j.issn.1000-7377.2025.03.022]

备注/Memo

备注/Memo:
基金项目:四川省绵阳市科技计划项目(2018YFZJ032)
更新日期/Last Update: 2024-02-05