Duzgun Arife Polat, Gulgez Baris, Ozmutlu Anil, Ertorul Didem, Bugdayci Güler, Akyurek Nurten, Coskun Faruk
Third Department of Surgery, Ankara Numune Teaching and Research Hospital, Sehit Adem Yavuz Sokak, No. 7/11 Kizilay, Ankara 06100, Turkey.
Dig Dis Sci. 2006 Dec;51(12):2400-3. doi: 10.1007/s10620-006-9334-7. Epub 2006 Nov 1.
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may result from several clinic situations and carries high morbidity and mortality risk, particularly in intensive care unit patients. The clinical spectrum changes from splanchnic hypoperfusion and intestinal ischemia to multiple organ failure. Previous studies demonstrated that serum D-lactate levels may be an early indicator in intestinal ischemia. This study aimed to investigate the relationship between intestinal ischemia and serum D-lactate levels during experimental IAH. Thirty-two male Wistar Albino rats weighing 250+/-50 g were divided into four groups. Three different intra-abdominal pressure (IAP) levels supplied by placement of an intraperitoneal Peritofix catheter and iso-osmotic polyethylene glycol infusion. Each of the IAP levels (15, 20, and 25 mm Hg groups) was checked with the monitor system and fixed for an hour. Control-group animals were not subjected to increased IAP. One hour later, 5-ml blood samples were taken for measurement of serum D-lactate levels and 2-cm intestinal tissue samples were taken 5 cm proximal to the ileocecal valve for histopathologic examination. Elevated serum D-lactate levels were recorded in animals with higher IAP levels. There was a positive correlation between serum D-lactate levels and IAP levels. Histological examinations of the intestinal tissue samples showed no significant pathologic changes in concordance with intestinal ischemia. Serum D-lactate levels may be an early indicator for increased IAP pressure before intestinal ischemic changes occur.
腹腔内高压（IAH）和腹腔间隔室综合征（ACS）可能由多种临床情况引起，且具有较高的发病率和死亡率风险，尤其是在重症监护病房患者中。临床症状从内脏灌注不足和肠道缺血转变为多器官功能衰竭。先前的研究表明，血清D-乳酸水平可能是肠道缺血的早期指标。本研究旨在探讨实验性IAH期间肠道缺血与血清D-乳酸水平之间的关系。将32只体重250±50 g的雄性Wistar白化大鼠分为四组。通过放置腹腔内Peritofix导管和输注等渗聚乙二醇来提供三种不同的腹腔内压力（IAP）水平。每个IAP水平组（15、20和25 mmHg组）均通过监测系统进行检查并固定一小时。对照组动物不施加升高的IAP。一小时后，采集5 ml血样以测量血清D-乳酸水平，并在回盲瓣近端5 cm处采集2 cm肠道组织样本进行组织病理学检查。IAP水平较高的动物血清D-乳酸水平升高。血清D-乳酸水平与IAP水平呈正相关。肠道组织样本的组织学检查显示与肠道缺血一致的无明显病理变化。血清D-乳酸水平可能是在肠道缺血性变化发生之前IAP压力升高的早期指标。
