Isfordink C J, Dekker D, Monkelbaan J F
Department of Gastro-Enterology, University Medical Centre Utrecht, Utrecht, the Netherlands.
Neth J Med. 2018 Mar;76(2):60-64.
Acute mesenteric ischaemia (AMI) is a life-threatening disease with a mortality rate around 60%. This high mortality rate is largely caused by diagnostic delay, which means there is a pressing need for a reliable biomarker. In clinical practice, serum lactate measurement is often used for the diagnosis of AMI. To assess the diagnostic value of serum lactate, we performed a literature search. Lactate has two different isomers. The well-known L-lactate, produced by anaerobic glycolysis, and the more unknown D-lactate which is only produced by intestinal bacteria. In this review, we present and evaluate the current literature on the diagnostic value of the measurement of both lactate isomers. Furthermore, we suggest another biomarker which might have the potential to serve as a useful diagnostic test in the future.
急性肠系膜缺血（AMI）是一种危及生命的疾病，死亡率约为60%。这种高死亡率很大程度上是由诊断延迟导致的，这意味着迫切需要一种可靠的生物标志物。在临床实践中，血清乳酸测量常用于AMI的诊断。为了评估血清乳酸的诊断价值，我们进行了文献检索。乳酸有两种不同的异构体。一种是众所周知的由无氧糖酵解产生的L-乳酸，另一种是相对不太为人所知的仅由肠道细菌产生的D-乳酸。在这篇综述中，我们展示并评估了当前关于两种乳酸异构体测量诊断价值的文献。此外，我们提出了另一种生物标志物，它可能在未来有潜力作为一种有用的诊断测试。
