1、8 急性胰腺炎低钙血症的机制研究黄鹤光 综述 冷希圣 审校$OF H b M1“,h1, b N1il。 “ -$OF? 3 b#1。S54 0 、 =# 9F 2, kmdh 3 M。B、0 EdmondsonFields1942 M n54N ,v $OF u 3“0T” ( Saponification) ,iv L L3。 7, Edmondson$OF h C_?C, u c #2 g, “5 5 v ( V2 g), 4$OF,%i Fv ? db ,5 04。1 );v D S( )A 6, 0A/,i PTH 67 6。 J F ?rs, ?r db,w V ?# 9, F ?
2、PTHO Q, s 8, 9。 4,$OF$ W ,Cu12,13。 FM, V dbY;(2) PTHM:t$OF,PTH , ?OPTH 6。 Robertson14BFPTH $OF, P dJF4 |, ? A 6 b 0,9F UCAM Pc; (3)PTH :?C,$OFPTH ,y7 $OF PTH 7 ; (4) PTH9F: Hermon Taylor15?C2- oO (2-macroglobulin-tripsincomplex) ? V b“ 3 =PTH, V ? 1y。McMahon9 A U$OFPTH9F。5$OFPTH TB, ,$OFPTH 6。 7?PTH
3、 fb ZE fb ZE _PTH,E PTHs 7 PT。 Mckay16NZE_41 $OF,PTH (A 6,h fi? 6 A, $OFPTH) 。 Imrie109M ,89 $OF, _PTH,v 6,3 4 d 7 S/, 6KA7 6 ,PTH, 。2.O :O s 9F 6 ? 17,18。O 6C$OF h , V P 6,17, 19。 PO ? b, AJ F G,9 ?20。O YV db l,17, 21。 Canale22 94$OF r H,/KA,? 3 -,X A 6,7 O ? ?。94MQT, Robertson14 O M 0M1,O Y b 0 ,9
4、 ?9FPTH。$OF C A, 5 。3. : VPTHs %, db7 323 。 Ryzen183OFh2003 M93 3 Chin JPancreatol, September 2003, Vol. 3, No. 3 24 ,% =% uY,% = /,$OFC Ai , 9i9 m4。V “5 A, s A U 19。、 T $OF H ? A。 Warshaw25 - v , i,8 L ?9F,26 。9?C VM% 1i,9F %=27。v 8 ( ) ?$OFi A28。9 L4A U,$OF 9F, 0/ i A1“,9 A HWM129。 OF 6, y OFC 6 A
5、, A v $OF,C A, A 6,yN, V ? 1y30。、F% YiML$OF ?C b A,F = 6,OF = 671% ,# 624% , 6112% , /#/25%。OF = 131。 Bhattacharya31 ,F =c 6, V ? 6O 、 、 M% Yi1, P %9F, ) =, 4 U%YiMM+s。9,$OFh 3 5 ,T9M ),B ? 3, B $OFh 3 V。 I D1 + , o5,f ,I.OF S,: 3, 2000. 327.2 Agarwal N, Pitchumon CS. Acute pancreatitis: a multisyst
6、emdisease. The Gastroenterologist, 1993, 1: 115-128.3 Storck G, Bjorntop P. Chemical composition of fat necrosis inexperimental pancreatitis in the rat. Scand J Gastroenterol,1971, 6: 225-230.4 Weir GC, Lesser PB, Drop LJ, et al. The hypocalcemia of a-cute pancreatitis. Ann Intern M ed, 1975, 83: 18
7、5-189.5 Izquierdo R, Bermes E, Sandberg L, et al. Serum calciummetabolism in acute experimental pancreatitis. Surgery, 1985,98: 1031-1037.6 Imrie CW, Allam BF, Ferguson JC, et al. Hypocalcaemia of a-cute pancreatitis. The effect of hypoalbuminemia. Curr MedRes Opin, 1976, 4: 101-116.7 McMahon M J, W
8、oodhead JS, Hayward RD. The nature ofhypocalcaemia in acute pancreatitis. Br J Surg, 1978, 65: 216-218.8 Hauser CJ, Kamrath RO, Sparks J, et al. Calcium homeostasisin patients with acute pancreatitis. Surgery, 1983, 94: 830-835.9 McMahon M J, Heyburn PJ, Playforth M J, et al. Parathyrodfunction duri
9、ng acute pancreatitis. Br J Surg, 1982, 69: 95-98.10 Imrie CW, Beastall GH, Allam BF, etal. Parathyroid hormoneand calcium homeostasis in acute pancreatitis. Br J Surg, 1978,65: 717-720.11 Drew SI, Joffe B, Vinik A. The first 24 hours of pancreatitis:changes in biochemical and endocrine hemostasis i
10、n patientswith pancreatitis compared with thosein control subjects under-going stress for reasons other than pancreatitis. Am J Med,1978, 64: 795-803.12 Immelman EJ, Bank S, Kirge H, et al. Roentgenologic andclinical features of intramedullary fat necrosis in bones in acuteand chronic pancreatitis.
11、Am J M ed, 1964, 36: 96-105.13 Boswell SH, Baylin GJ. Metastatic fat necrosis and lytic bonelesions in a patient with painless acute pancreatitis. Radiology,1973, 106: 85-86.14 Robertson GM, Moore EW, Switz DM, et al. Inadequateparathyroid response in acute pancreatitis. N Engl J Med,1976, 294: 512-
12、516.15 Hermon Tayor J, Majee AI, Grant DAW, et al. Cleavage ofpeptide hormones by beta-2-macroglobulin-trypsin complex andits relation to the pathogenesis and chemotherapy of acute pan-creatitis. Clin Chim Acta, 1981, 109: 203-209.16 Mckay C, Beastall GH, Imrie CW, et al. Circulating intactparathyro
13、id hormone levels in acute pancreatitis. Br J Surg,1994, 81: 357-360.17 Paloyan E, Paloyan D, Harper PV, et al. The role of glucagonhypersecretion in the relationship of pancreatitis and hyper-parathyriodism. Surgery, 1967, 62: 167-173.18 Imrie CW, Beastall GH, Mckay AJ, et al. Calcitonin andparathy
14、roid hormone (PTH) levels in clinicalacutepancreatits.Gut, 1983, 24: A597.19 Donowitz M , Hendler R, Spiro HM, et al. Glucagon secretionin acute and chronic pancreatic. Ann Intern Med, 1975, 83:778-781.20 Bierge SJ, Avioli LV. Glucagon induced hypocalcemia in man.J Clin Endocrinol M etab, 1969, 29:
15、213-218.21 Condon JR, Ives D, Knight M J, et al. The aetiology ofhypocalcemia in acute pancreatitis. Br J Surg, 1975, 62: 115-118.22 Canale DD, Donabedian RK. Hypercalcitoninemiain acute pan-creatitis. J Clin Endocrinol M etab, 1975, 40: 738-741.23 Rude RK, Oldham SB, Singer FR, et al. Functional hy
16、pothy-roidism and parathyroid hormone end-organ resistance in humanmagnesium deficiency. Clin Endocrinol, 1976, 5: 209-224.24 Ryzen E, Rude PK. Low intracellular magnesium levels in pa-184 OFh2003 M93 3 Chin J Pancreatol, September 2003, Vol. 3, No. 3tients with acute pancreatitis and hypocalcemia.
17、West J Med,1990, 152: 145-148.25 Warshaw AL, Lee KH, Napier TW, et al. Depression ofserum calcium by increased plasma free fatty acid in the rat: amechanism for hypocalcemiain acutepancreatitis. Gasteroente-rology, 1985, 89: 814-820.26 Zaloga GP, Willey S, Tomasic P, et al. Free fatty acid altercalc
18、ium binding: a cause for misinterpretation of serum calciumvalues and hypocalcemia in critical illness. J Clin EndocrinolMetab, 1987, 64: 1010-1014.27 Allam BF, Imire CW. Serum-ionized calcium in acute pancre-atiits. Br J Surg, 1977, 64: 665-668.28 Dettelbach M A, Deftos LJ, Stewart AF, et al. Intra
19、perifonealfree fatty acids induce severe hypcocalcemia in rats: a model forthe hypocalcemia of pancreatitis. J Bone and Mineral Res,1990, 5: 1249-1255.29 Domschke S, Malfertheiner P, Uhl W, etal. Free fatty acid inserum of patients with acute necrotizing and edematous pancre-atitis. Int J Pancreatol
20、, 1993, 13: 105-110.30 Rattner DW, Napolitano LM, Corsetti J, et al. Hypocalcemiain experimental pancreatitis occurs independently of changes inserum nonesterified fatty levels. Int J Pancreatol. 1990, 6:249-262.31 Bhattacharya SK, Luther RW, Pate JW, et al. Soft tissuecal-cium and magnesium content
21、 in acute pancreatitis in the dog:calcium accumulation, a mechanism for hypocalcemia in acutepancreatitis. J Lab Clin Med, 1985, 105: 422-427.( l : 2002-12-13)(I : )S 内镜超声引导下胰管抽吸术:诊断价值和安全性摘自: Lai R, Stanley MW, Bardales R, et al. Endoscopic ultrasound-guided pancreaticduct aspiration: di-agnostic yi
22、eld and safety. Endoscopy, 2002,34: 715-720= 2( EUS)/%,O B OF ?s ZE,9OF 5%h4N 。 MD, V N yO5 f。N,TB EU S/O5,O ( EUS-PDA) r。ZE l“1999 M32000 M10WEUS-PDA12 , o8, 34, M -48 86 , (70 。O5 : (1) hyO5 f,P5 8 = h*A% ?( IPM T) 7 , 2 EUS?CO5 =; (2)O5 =E L8 v O5 f, v%1 ; ( 3) “5h 2_4 UdO5 =E L8 v O5 f4 , N 0MIP
23、M T。O5 K:Oh 3mm,O8 2 mm,O 1 mm, M S ab z。 TOF = 2D = S5/ 。Pentax FG-32UAFG-36UX 2 =,o D、,:、rJ? JS。 /4 aE 75。,O“1 y AV*19| , (22|,?。,OC E=C, L H = 2 U5 8 ,O5 J,O 。UV5 8| - T, 。“ l“ !H ,* 5 ,- X D S f 。 TV d 。 i4i? 3。 b,.e, V 。 gd Q, 5 d,i s 。T 12 EUS-PDA (。O5Kv521 mm, (11. 3 mm。 12 5 *AA8 %, 1 i%s*A, ,6 n5 = h*A ?, 3 OF M“ ,h L。 6 5 H # L8 ?_FNA LOFF, 2 VO5 %_, 1 d%, 0,2 。K1 p h,%_?Cv 7 3 x _H%。 EUS-PDA9 q75% , A5 v E 7 100%。 18 d13, (8, (i? 3。 6 5= h*A ?5 Hr,1 6 M1 %h。 5 OF4 13= , 1 18 d 。5 sO, 6 Hh f。OFp g s , 10 H。(/190:)185OFh2003 M93 3 Chin JPancreatol, September 2003, Vol. 3, No. 3
