The change of intestinal mucosal barrier in severe acute pancreatitis

Objective:To investigate the mechanism of the changes of the intestinal mucosal barrier in Severe acute pancreatitis.Methods:Twenty patients with Severe acute pancreatitis were admitted and 10 volunteers as the control group.The levels of serum tumor necrosis factor alpha(TNF_α)、nitric oxide(NO)、diamine oxidase(DAO) and the concentration of plasma endotoxin(ET) were measured.The ratio of lactulose to mannitol in urine was detected by HPLC with Pulsed Electrochemical Detection.Results:Compared with the control group,significantly increasing parameters could be seen in all the patients with Severe acute pancreatitis,including the ratio of lactulose to mannitol in urine (P0.01) and the levels of blood ET、NO、TNF_α and DAO(P0.01).Conclusion:It is concluded that in the patients with Severe acute pancreatitis,intestinal mucosal barrier was injured and gut permeability was increased.Blood endotoxin、TNF_α and NO may play important roles in the damage of gut barrier alone or together.While DAO can reflect the integrity of the intestinal mucosa.