Gumaste Upendra R, Joshi Mukund M, Mourya Devendra T, Barde Pradip V, Shrivastav Ghanshyam K, Ghole Vikram S
Division of Biochemistry, Department of Chemistry, University of Pune, Pune 411007, India.
World J Gastroenterol. 2005 Feb 14;11(6):912-6. doi: 10.3748/wjg.v11.i6.912.
Intestinal ischemia (Ii) is an abdominal emergency due to blockade of the superior mesenteric artery resulting in 60-100% mortality if diagnosed late. Changes in several biochemical parameters such as D (-)-lactate, Creatinine kinase isoenzymes and lactate dehydrogenase suggested for early diagnosis, lack specificity and sensitivity. Therefore a biochemical parameter with greater sensitivity needs to be identified.
Wistar male rats were randomly assigned into two groups; control sham operated (n = 24) and ischemic test (n = 24) group. Superior mesenteric arterial occlusion was performed in the ischemic test group for 1 h. Alcohol dehydrogenase (ADH) was estimated in blood from portal vein, right ventricle of heart, dorsal aorta (DA) and inferior vena cava (IVC). The Serum glutamic acid pyruvate transaminase (SGPT) was also estimated in blood from portal vein and right ventricle of heart.
A significant increase (P<0.001) in the levels of ADH in both portal blood as well as heart blood of the test group (232.72+/-99.45 EU and 250.85+/-95.14 EU, respectively) as compared to the control group (46.39+/-21.69 EU and 65.38+/-30.55 EU, respectively) were observed. Similarly, increased levels of ADH were observed in blood samples withdrawn from DA and IVC in test animals (319.52+/-80.14 EU and 363.90+/-120.68 EU, respectively) as compared to the control group (67.68+/-63.22 EU and 72.50+/-58.45 EU, respectively). However, in test animals there was significant increase in SGPT in portal blood (P = 0.054) without much increase in heart blood.
Significant increase in the levels of ADH in portal and heart blood within 1 h of SMA occlusion without increase in SGPT in heart blood, suggests that the origin of ADH is from ischemic intestine and not from liver. Similarly, raised ADH levels were found in DA and IVC as well. IVC blood does represent peripheral blood sample. A raised level of ADH in test animals confirms it to be a potential marker in the early diagnosis of Ii.
肠缺血(II)是一种腹部急症,由肠系膜上动脉阻塞引起,若诊断较晚,死亡率可达60 - 100%。几种生化参数如D(-)-乳酸、肌酸激酶同工酶和乳酸脱氢酶的变化虽被建议用于早期诊断,但缺乏特异性和敏感性。因此,需要确定一种更具敏感性的生化参数。
将雄性Wistar大鼠随机分为两组;假手术对照组(n = 24)和缺血试验组(n = 24)。对缺血试验组进行肠系膜上动脉闭塞1小时。测定门静脉、心脏右心室、背主动脉(DA)和下腔静脉(IVC)血液中的乙醇脱氢酶(ADH)。还测定门静脉和心脏右心室血液中的血清谷丙转氨酶(SGPT)。
与对照组相比,试验组门静脉血和心脏血中ADH水平显著升高(P<0.001)(分别为232.72±99.45 EU和250.85±95.14 EU),对照组分别为46.39±21.69 EU和65.38±30.55 EU。同样,与对照组相比,试验动物从DA和IVC采集的血样中ADH水平也升高(分别为319.52±80.14 EU和363.90±120.68 EU),对照组分别为67.68±63.22 EU和72.50±58.45 EU。然而,试验动物门静脉血中SGPT显著升高(P = 0.054),心脏血中升高不多。
肠系膜上动脉闭塞1小时内门静脉和心脏血中ADH水平显著升高,而心脏血中SGPT未升高,表明ADH起源于缺血肠而非肝脏。同样,在DA和IVC中也发现ADH水平升高。IVC血确实代表外周血样本。试验动物中ADH水平升高证实其为肠缺血早期诊断的潜在标志物。