急性肠系膜血管病变时的血清酶谱变化  

Changes of serum enzymes in acute mesenteric vasculopathy

作　　者：胡路[1] 张福先[1] 

机构地区：[1]北京大学第九临床学院首都医科大学附属北京世纪坛医院血管外科,100038

出　　处：《中华普通外科杂志》2014年第4期285-288,共4页Chinese Journal of General Surgery

摘　　要：目的探讨血清酶谱在急性肠系膜血管病变（acute mesenteric vasculopathy，AMV）与几种外科急腹症中的变化，验证其对AMV的早期诊断意义。方法建立家兔急性肠系膜动脉缺血、急性肠系膜静脉缺血、急性机械性肠梗阻、急性绞窄性肠梗阻、急性胃穿孔、急性胰腺炎、假手术、空白对照的动物模型，在模型建立后0、1、3、6、9h抽取外周静脉血化验血清酶谱，分析酶谱变化，找出组问差异。结果与空白对照相比，AMV的血清酶谱随缺血时间延长明显升高：静脉缺血组在阻断3h后AIJT（alanine aminotransferase，谷丙转氨酶），ALP（alkaline phosphatase，碱性磷酸酶），r—GT（glutamyl transfeahe enzyme，谷氨酰转移酶）即出现显著性变化，LDH（lactate dehydrogenase，乳酸脱氢酶）在阻断6h后出现显著性变化（P〈0．05）。动脉缺血组在阻断6h后ALT出现显著性变化（P〈0．05）。AIJT在AMV和急性胃穿孔、机械性肠梗阻、绞窄性肠梗阻之间的变化差异有统计学意义（P〈0．05）；r—GT在急性肠系膜动脉缺血和静脉缺血之间的变化差异有统计学意义（P〈0．05）。结论血清酶谱变化有助于AMV的早期诊断。Objective To study changes of serum enzymes among acute mesenteric vasculopathy （AMV） and several surgical acute abdomens for early diagnosis of acute mesenteric vasculopathy. Methods Rabbit models were established for acute mesenteric artery ischemia, acute mesenteric venous ischemia, acute mechanical ileus, acute strangulated intestinal obstruction, acute gastric perforation, acute pancreatitis, sham group, blank control group. Serum enzymes were tested after 0, 1, 3, 6, 9 h. Result Compared with blank control, acute mesenteric vasculopathy experienced significantly alterations of the serum enzymes. ALT （alanine aminotransferase ）, ALP （alkaline phosphatase ）, r-GT （glutamyl transferthe enzyme ） were significantly higher after mesenteric veins blocked 3 hours, LDH （lactate dehydrogenase） was significantly higher after mesenteric venous blocked 6 hours （P 〈 0. 05 ）. ALT was significantly higher after mesenteric artery blocked 6 hours （ P 〈 0. 05 ）. Elevated ALT were statistically different in acute mesenteric vasculopathy compared with blank control, sham group, gastric perforation, mechanical ileus, and strangulated intestinal obstruction （ all P 〈 0. 05 ） ; r-GT level was statistically different between acute mesenteric artery ischemia and acute mesenteric venous ischemia. Conclusions Mesurements of serum enzymes level are helpful to make early diagnosis of acute mesenteric vasculopathy.

关 键 词：肠系膜血管闭塞 疾病模型 动物 酶类 早期诊断 

分 类 号：R656.1[医药卫生—急诊医学]