直接肾素抑制剂对大鼠急性胰腺炎的保护作用及机制

Angiotensin-II and acute pancreatitis

Acute pancreatitis (AP) is one of the most common acute abdominal diseases in the digestive system. The total mortality of AP is about 5%-10%; however, the mortality of severe acute pancreatitis (SAP) is about 30%-40%. In recent years, the overall mortality rate of AP has not changed much, but the incidence rate of AP is increasing year by year. AP has become the second major cause of hospitalization in department of gastroenterology, and also is one of the most expensive diseases. According to the revised Atlanta classification criteria in 2012, AP can be divided into mild acute pancreatitis (MAP), moderate severe acute pancreatitis (MSAP), and SAP. About 60% of AP cases are MAP, which is often self-limited, has no complications, and is associated with a low mortality rate; however, about 30% of AP patients had MSAP, about 10% of which could get worse to turn to SAP. Persistent organ failure (POF) is the main cause of the progression of SAP, and also is the main cause of death in the early stage of AP. Pancreatic necrosis with secondary infection is the main cause of death in the late stage of AP. The progression and prognosis of AP are closely related to the early treatment and intervention, but the complicated pathogenesis of AP affects the efficacy of early treatment. Since the pathogenesis of AP has not been fully elucidated, there is a lack of specific treatment. At present, the pathogenesis of AP is generally recognized as "cascade waterfall of leukocyte over-activation-inflammatory factors", "intestinal bacterial translocation and secondary attack", "apoptosis", "pancreatic microcirculation disorder", etc. These theories indicate that the pathogenesis of AP is a complex and multifactorial pathophysiological process. In recent years, the role of angiotensin-Ⅱ (Ang-Ⅱ), an active substance in the renin-angiotensin system, in the occurrence and development of AP has gradually attracted the attention of scholars. Therefore, an in-depth study of the relationship between Ang-Ⅱ and AP may contribute to the clinical understanding and treatment of AP. In this paper, we review the relationship between Ang-Ⅱ and AP.