Graeber G M, Clagett G P, Wolf R E, Cafferty P J, Harmon J W, Rich N M
Division of Surgery, Walter Reed Army Institute of Research, Washington, DC.
Chest. 1990 Mar;97(3):521-7. doi: 10.1378/chest.97.3.521.
Experimental studies have shown that peripheral serum creatine kinase and lactate dehydrogenase change with bowel infarction. Some clinical reports have suggested that similar changes occur in patients. This prospective study documents the changes in these enzymes associated with acute myocardial infarction, acute bowel necrosis (MES INF), and uncomplicated abdominal aortic reconstruction. Analysis of 15 patients with AMI, 13 patients undergoing major AAS, and eight patients with MES INF has shown that these conditions may be differentiated by analysis of serum CK and LD isoenzymes. The study suggests that in the absence of electrocardiographic changes, a patient with epigastric distress with elevated levels of serum CK and either CK-MB or CK-BB bands present may well have a mesenteric rather than a myocardial infarction. Acute myocardial infarction can be ruled out further through analysis of serum LD1/LD2 ratios.
实验研究表明，外周血清肌酸激酶和乳酸脱氢酶会随着肠梗死而发生变化。一些临床报告表明，患者也会出现类似的变化。这项前瞻性研究记录了与急性心肌梗死、急性肠坏死（肠系膜梗死）和无并发症的腹主动脉重建相关的这些酶的变化。对15例急性心肌梗死患者、13例接受大型腹主动脉手术的患者和8例肠系膜梗死患者的分析表明，通过分析血清肌酸激酶（CK）和乳酸脱氢酶（LD）同工酶可以区分这些情况。该研究表明，在没有心电图变化的情况下，出现上腹部不适且血清CK水平升高以及存在CK-MB或CK-BB条带的患者很可能患有肠系膜梗死而非心肌梗死。通过分析血清LD1/LD2比值可以进一步排除急性心肌梗死。
