拜读《辽宁中级医刊》1981年第6期38页(四川医学院附属医院儿科、病理科)报道一例“呻吟、惊厥、呼吸不规则”临床病理讨论一文后,收益很大,但问题的阐述以个人拙见并未尽然。现提出个人肤浅之识,供作者、读者参考。该例是4个月的男婴,患急性胰腺炎,发生了呼吸衰竭。作者在讨论中认为发生机理是胰腺脑病所致。这点个人认为是正确的,无疑义的。但不够全面,比如该例发生的“右下肺不张”用胰腺脑病就不太好解释,况且用了山梨醇等药,呼吸衰竭更加严重,也单用胰腺脑病,不太好解释。故个人认为除了胰腺脑病这个因素外,又由于急性胰腺炎所致卵磷酯酶增加,大量释放,破坏了肺泡表面活性物质(使肺泡表面活性物质分解加速)。因为肺泡表面活性物质化学成分90％是脂质,磷酯占脂质中80％,其中以二棕榈基卵磷脂(dipalmitory lecithin)简称DPL约占40～50％。急性胰腺炎释放出的卵磷酯酶增加,加速 Read “LiaoningMedicalMedicine” in 1981 sixth issue 38 (Sichuan Medical College Hospital pediatrics, pathology) reported a case of “moaning, convulsions, respiratory irregularity,” a clinical and pathological discussion, the great benefits, but the problem is elaborated My humble opinion is not entirely personal. Present personal superficial knowledge, for the author, reader reference. This is a 4-month-old baby boy suffering from acute pancreatitis and respiratory failure. The authors in the discussion that the mechanism is caused by pancreatic encephalopathy. This is personally considered to be correct, no doubt. But not comprehensive enough, such as the case of “right lower lung atelectasis” with pancreatic encephalopathy is not very good to explain, Moreover, the use of sorbitol and other drugs, respiratory failure is more serious, also single pancreatic encephalopathy, not too good to explain. So personally think that in addition to this factor of pancreatic encephalopathy, but also because of acute pancreatitis caused by increased lecithin, a large number of release, destruction of alveolar surfactant (to accelerate the decomposition of alveolar surfactant). Because 90% of the alveolar surfactant is a lipid, phospholipids account for 80% of the lipids, of which about 40 to 50% is abbreviated as dipalmitory lecithin. Acute pancreatitis release of lecithin increased, accelerated