Department of General Surgery, International Adn Hospital, Gaziantep-Türki̇ye.
Department of Physiology, Gaziantep University Faculty of Medicine Gaziantep-Türki̇ye.
Ulus Travma Acil Cerrahi Derg. 2024 Jan;30(1):1-8. doi: 10.14744/tjtes.2024.38399.
Acute mesenteric ischemia (AMI) is responsible for one in a thousand emergency hospital admissions in America and Europe and is associated with high morbidity and mortality rates. Current diagnostic and treatment methods fall short of desired outcomes, often resulting in delayed diagnoses and difficulties in detecting ischemic bowel tissue during treatment. This study evaluates the diagnostic value of commonly used biochemical markers in clinical practice-creatine kinase, C-reactive protein (CRP), and lactate dehydrogenase (LDH)-alongside blood flow measurements using laser Doppler in a rat model of experimental mesenteric ischemia. We also compare these markers with pathological ischemia scoring.
Rats were divided into five groups: control, 1 hour, 2 hours, 3 hours, and 4 hours. Mesenteric ischemia was induced for the respective durations in each group. After these periods, we measured blood flow using laser Doppler. We also collected blood samples and intestinal biopsies for biochemical parameter analysis. These values were assessed in relation to intestinal viability using the Chiu ischemia scoring system.
Blood flow measurement with laser Doppler correlated with both the duration and severity of bowel ischemia. No significant relationship was found between CRP levels and the duration of ischemia. However, creatine kinase and lactate dehydrogenase (LDH) levels were significantly higher in ischemia lasting into the third and fourth hours.
Creatine kinase and lactate dehydrogenase (LDH) levels may be useful biomarkers in patients with suspected acute mesenteric ischemia (AMI). Blood flow measurements using laser Doppler can accurately identify intestinal loops for resection during surgery.
急性肠系膜缺血（AMI）在美国和欧洲，每千例急症住院患者中就有一例，其发病率和死亡率都很高。目前的诊断和治疗方法都达不到预期的效果，往往导致诊断延迟，在治疗过程中难以检测到缺血肠组织。本研究在实验性肠系膜缺血大鼠模型中评估了临床常用生化标志物（肌酸激酶、C 反应蛋白（CRP）和乳酸脱氢酶（LDH））以及激光多普勒血流测量的诊断价值。我们还将这些标志物与病理缺血评分进行了比较。
大鼠分为五组：对照组、1 小时组、2 小时组、3 小时组和 4 小时组。每组分别诱导肠系膜缺血相应的持续时间。在这些时间段之后，我们使用激光多普勒测量血流。我们还收集了血液样本和肠活检标本，用于生化参数分析。这些值与肠组织活力评估采用 Chiu 缺血评分系统。
激光多普勒血流测量与肠缺血的持续时间和严重程度相关。CRP 水平与缺血持续时间之间未发现显著相关性。然而，在持续 3 小时和 4 小时的缺血中，肌酸激酶和乳酸脱氢酶（LDH）水平显著升高。
肌酸激酶和乳酸脱氢酶（LDH）水平可能是疑似急性肠系膜缺血（AMI）患者有用的生物标志物。激光多普勒血流测量可准确识别手术中需要切除的肠环。
