Kazmierczak S C, Lott J A, Caldwell J H
Department of Pathology, Ohio State University, Columbus.
Clin Chem. 1988 Feb;34(2):281-8.
Mesenteric vascular occlusion and intestinal obstruction are difficult-to-diagnose medical emergencies. We evaluated a large panel of biochemical markers as diagnostic and prognostic indicators in a rat model of intestinal infarction and partial, complete, and strangulated intestinal obstruction. After intestinal infarction and obstruction, laboratory data are distinctly abnormal. Serum urea nitrogen dramatically increased in all groups, but most rapidly in the groups with infarction and strangulated obstruction. Inorganic phosphorus proved to be a sensitive indicator of infarction, but less so for any form of obstruction. While all members in the infarct group demonstrated significant increases in the aminotransferases, creatine kinase, and alkaline phosphatase, such increases in the groups with obstruction were less pronounced. Serum maltase assays revealed decreasing activities in all members of the groups with complete and strangulated obstruction, but in only 17% of the rats with partial obstruction. Serum maltase activity increased from abnormally low values after surgery to abnormally high values in the six animals that recovered from partial intestinal obstruction. The proportion of hexosaminidase A (of total beta-N-acetylhexosaminidase, EC 3.2.1.30) was generally abnormal in rats with complete and strangulated obstruction.
肠系膜血管闭塞和肠梗阻是难以诊断的医疗急症。我们在大鼠肠梗死及部分、完全和绞窄性肠梗阻模型中评估了一大组生化标志物作为诊断和预后指标。在肠梗死和肠梗阻后,实验室数据明显异常。所有组的血清尿素氮均显著升高,但在梗死组和绞窄性梗阻组中升高最为迅速。无机磷被证明是梗死的敏感指标,但对任何形式的梗阻而言敏感性稍低。梗死组所有大鼠的转氨酶、肌酸激酶和碱性磷酸酶均显著升高,而梗阻组的此类升高则不太明显。血清麦芽糖酶检测显示,完全性和绞窄性梗阻组所有大鼠的麦芽糖酶活性均下降,但仅17%的部分梗阻大鼠麦芽糖酶活性下降。部分肠梗阻恢复的6只动物的血清麦芽糖酶活性从术后异常低值升至异常高值。完全性和绞窄性梗阻大鼠的己糖胺酶A(占总β-N-乙酰己糖胺酶的比例,EC 3.2.1.30)比例通常异常。