Taylor B M, Jamieson W G, Durand D
Can J Surg. 1979 Jan;22(1):40-5.
Acute mesenteric ischemia is extremely difficult to diagnose because peritoneal signs are absent until the bowel becomes necrotic and irretrievably damaged. So far the only reliable diagnostic procedure has been mesenteric angiography. The present study verifies that significant elevations of serum inorganic phosphate concentrations occur in dogs after mesenteric occlusion; the authors' initial clinical studies in humans support these experimental findings. Detailed analysis of body fluid and soft tissue phosphate content shows that the high phosphate load originates in the sloughing intestinal mucosa; if this phosphate escapes filtration by the liver it enters the systemic circulation. Simple measurement of the inorganic phosphate concentrations of the serum and peritoneal fluid may lead to earlier diagnosis of acute intestinal ischemia and a successful revascularization procedure to prevent its progression to infarction.
急性肠系膜缺血极难诊断，因为在肠管发生坏死且无法挽回地受损之前不会出现腹膜体征。到目前为止，唯一可靠的诊断方法一直是肠系膜血管造影术。本研究证实，肠系膜闭塞后的犬血清无机磷酸盐浓度会显著升高；作者最初在人体上进行的临床研究支持了这些实验结果。对体液和软组织磷酸盐含量的详细分析表明，高磷酸盐负荷源自肠黏膜的脱落；如果这种磷酸盐未被肝脏滤过，就会进入体循环。简单测量血清和腹膜液中的无机磷酸盐浓度可能会导致急性肠缺血的早期诊断，并成功进行血管重建手术以防止其发展为梗死。
