肠系膜上静脉血栓形成早期诊断的实验研究  

Experimental study on diagnosis of superior mesenteric venous thrombosis in early stage

作　　者：贾向博[1] 陈建立[1] 张国志[1] 

机构地区：[1]河北联合大学附属医院普外科,河北唐山063000

出　　处：《中国医药导报》2014年第15期163-166,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题计划(编号20100130)

摘　　要：目的探讨肠脂肪酸结合蛋白(IFABP)、α-谷胱甘肽S转移酶(α-GST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)在肠系膜上静脉血栓形成(SMVT)早期诊断的价值,并进行综合分析判断肠道损伤情况。方法 SD大鼠108只,随机分为对照组(C组)、肠系膜上静脉阻断8 cm组(A组)及肠系膜上静脉阻断4 cm组(B组),3组按不同时间点(2、8、24、36、48、72 h)分为6个亚组,抽取下腔静脉血,检测血清中IFABP、α-GST、LDH和CK-MB的活性及变化规律,光镜下观察各时间点肠道的病理学变化。结果与C组相比,A组IFABP于术后2 h即明显升高(P<0.05),36 h达高峰后出现下降趋势;α-GST术后2 h明显升高(P<0.05),36 h后维持在较高水平;LDH、CK-MB升高较晚,术后8 h明显升高(P<0.05),但随着肠道组织损伤加重而逐渐升高。B组IFABP于术后2 h即明显升高(P<0.05);α-GST、LDH于术后8 h明显升高(P<0.05),36 h达高峰后出现下降趋势;CK-MB升高较晚,术后24 h明显升高(P<0.05),亦于术后36 h达高峰后出现下降趋势。肠道损伤情况:A组中肠道损伤随时间延长而逐渐加重,术后72 h出现肠道全层损坏;B组术后36 h损伤最严重,36 h后随时间逐渐减轻。结论综合分析血清中IFABP、α-GST、LDH和CK-MB的活性及变化趋势有助于SMVT的早期诊断及判断肠道组织的损伤情况。Objective To investigate the role of intestinal fatty acid-binding protein （IFABP）, α-glutatione S transferase （α-GST）, LDH and CK-MB in the early diagnosis of SMVT and the intestinal damage. Methods A total number of 108 SD rats were randomly divided into control group （group C）, blocking superior mesenteric vein of 8 em group （group A） and blocking superior mesenteric vein of 4 cm group （group B）. Inferior vena cava blood samples were collected sequentially at 2, 8, 24, 36, 48 and 72 hours after operation for observing the activity and change rule of IFABP, α-GST, LDH and CK-MB. The morphological changes of intestinal tissues were observed with light microscopy. Results Compared with the group C, the activity of IFABP in group A was significantly higher at 2 h after operation （P 〈 0.05）, peaking at 36 h then gradually decrease; the activity of α-GST was significantly higher at 2 h after operation （P 〈 0.05）, peaking at 36 h and keeping at a higher level; the activity of LDH and CK-MB were significantly higher at 8 h after operation （P 〈 0.05）, then elevated persistently as the intestinal tissue damage accelerated gradually. In the group B, the activity of IFABP was significantly higher at 2 h after operation （P 〈 0.05）; the activity of α-GST and LDH were significantly higher at 8 h after operation （P 〈 0.05）, peaking at 36 h after operation then gradually decreased; the activity of CK-MB were significantly higher at 24 h after operation （P 〈 0.05）, peaking at 36 h after operation then gradually decreased. The injury of intestinal tissue： in the group A, intestinal injury gradually increased with time, and had intestinal full-thickness damage at 72 h after operation; in group B, intestinal injury was the most serious at 36 h after operation, then the damage gradually reduced. Conclusion It is beneficial to diagnosis of SMVT in early stage and estimate the intestinal tissue damage by detecting the activity and changing rule of IFABP, α-GST, LDH and C

关 键 词：肠系膜上静脉血栓形成 肠脂肪酸结合蛋白 α-谷胱甘肽S转移酶 乳酸脱氢酶 肌酸激酶同工酶 

分 类 号：R656.6[医药卫生—外科学]