Aköz Ayhan, Türkdoğan Kenan Ahmet, Kahraman Çetin Nesibe, Kum Selen, Duman Ali, Türe Mevlüt, Demirkıran Ahmet Ender
Department of Emergency Medicine, Adnan Menderes University Faculty of Medicine, Aydın-Turkey.
Ulus Travma Acil Cerrahi Derg. 2018 Nov;24(6):507-513. doi: 10.5505/tjtes.2018.69710.
The objective of the current study was to investigate the value of the ischemic biomarkers endothelial cell-specific molecule-1 (endocan) and signal peptide-CUB-EGF domain-containing protein-1 (SCUBE-1) in the diagnosis and assessment of earlystage and irreversible damage in acute mesenteric ischemia.
An experimental mesenteric ischemia reperfusion model was designed using 54 rats. Nine groups were created: Three sham groups [Groups I (30th minute), IV (2nd hour), and VII (6th hour)], in which only blood and tissue specimens were sampled; 3 ischemia groups [Groups II (30th minute), V (2nd hour), and VIII (6th hour)], in which blood and tissue specimens were sampled after ligation of the superior mesenteric artery (SMA); and 3 reperfusion groups [Groups III (30th minute), VI (2nd hour), and IX (6th hour)], in which blood and tissue specimens were sampled after declamping the SMA and reperfusion for 1 hour. SCUBE-1 and endocan samples obtained from blood and tissue were examined histopathologically.
The SCUBE-1 level was higher in the ischemia groups when compared with the sham groups (p<0.05), and the endocan level was markedly different in the late ischemia (6th hour) group. When these 2 markers were used together to assess irreversible mesenteric damage in the histopathological examination, the sensitivity in distinguishing between reversible or irreversible damage was 94.1% with a specificity of 73.7%.
The elevation of SCUBE-1 alone seems to be significant for predicting early mesenteric ischemia in laboratory rats. The combination of SCUBE-1 and endocan may be useful to detect irreversible intestinal damage.
本研究的目的是探讨缺血生物标志物内皮细胞特异性分子-1（内皮素）和含信号肽-CUB-表皮生长因子结构域蛋白-1（SCUBE-1）在急性肠系膜缺血早期诊断及评估不可逆损伤中的价值。
设计了一个使用54只大鼠的实验性肠系膜缺血再灌注模型。分为9组：3个假手术组[第I组（30分钟）、第IV组（2小时）和第VII组（6小时）]，仅采集血液和组织样本；3个缺血组[第II组（30分钟）、第V组（2小时）和第VIII组（6小时）]，在结扎肠系膜上动脉（SMA）后采集血液和组织样本；3个再灌注组[第III组（30分钟）、第VI组（2小时）和第IX组（6小时）]，在松开SMA夹并再灌注1小时后采集血液和组织样本。对从血液和组织中获得的SCUBE-1和内皮素样本进行组织病理学检查。
与假手术组相比，缺血组的SCUBE-1水平更高（p<0.05），且晚期缺血（6小时）组的内皮素水平有显著差异。在组织病理学检查中，当将这两种标志物一起用于评估不可逆性肠系膜损伤时，区分可逆或不可逆损伤的敏感性为94.1%，特异性为73.7%。
单独SCUBE-1升高似乎对预测实验大鼠早期肠系膜缺血具有重要意义。SCUBE-1和内皮素联合使用可能有助于检测不可逆性肠损伤。
