The association of viral hepatitis and acute pancreatitis.
The association of viral hepatitis and acute pancreatitis.
复制标题
病毒性肝炎与急性胰腺炎的关联。
DOI：
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发表时间：
1972
期刊：
影响因子：
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通讯作者：
H. Rinderknecht
中科院分区：
文献类型：
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作者：
Geokas Mc;H. Olsen;Swanson;H. Rinderknecht
从死于肝炎、胰腺炎或胰腺肿瘤以外的原因的患者中获得的24个胰腺的组织学特征包括不同程度的自溶、罕见的炎性反应灶，但没有出血性脂肪坏死或血管壁弹性组织破坏（弹性组织溶解）。这些胰腺提取物中的弹性蛋白酶检测显示无游离酶，但弹性蛋白酶原含量不一。回顾33例氟烷麻醉致死性肝坏死患者的尸检结果，仅2例显示急性胰腺炎改变。另一方面，回顾16例暴发性病毒性肝炎，发现急性胰腺炎的特征性改变有七种：间质水肿、出血性脂肪坏死、炎症反应和血管壁弹性蛋白溶解。一个胰腺提取物中的弹性蛋白酶的测定显示游离形式的酶的大部分。此外，44例病毒性肝炎患者的尿淀粉酶测定显示该酶水平升高（2583 +/- 398平均值+/-标准误，13例患者每100 ml Somogyi单位，或29.5%）。有证据表明急性胰腺炎有时会并发病毒性肝炎。虽然直接证明病毒胰腺参与目前是不可行的，一个合理的假设是先进的，强调类似的机制，组织参与肝脏和胰腺可能带来的肝炎病毒。
The histological features of 24 pancreases obtained from patients who died of causes other than hepatitis, pancreatitis or pancreatic tumors, included a variable degree of autolysis, rare foci of inflammatory reaction but no hemorrhagic fat necrosis or destruction of elastic tissue in vessel walls (elastolysis). Assays of elastase in extracts of these pancreases showed no free enzyme, but varying amounts of proelastase.A review of autopsy findings in 33 patients with fatal liver necrosis attributed to halothane anesthesia, demonstrated changes of acute pancreatitis only in two. On the other hand, a review of 16 cases of fulminant viral hepatitis revealed changes characteristic of acute pancreatitis in seven - interstitial edema, hemorrhagic fat necrosis, inflammatory reaction and frequently elastolysis in vessel walls. Determination of elastase in extracts of one pancreas showed the bulk of the enzyme in free form. Furthermore, assays of urinary amylase in 44 patients with viral hepatitis showed increased levels of this enzyme (2583 +/- 398 mean value +/- standard error, Somogyi units per 100 ml in 13, or 29.5 percent). The evidence suggests that acute pancreatitis may at times complicate viral hepatitis. Although direct proof of viral pancreatic involvement is not feasible at present, a rational hypothesis is advanced which underlines similar mechanisms of tissue involvement in both liver and pancreas that may be brought about by the hepatitis viruses.