Graeber G M, Cafferty P J, Reardon M J, Curley C P, Ackerman N B, Harmon J W
Ann Surg. 1981 Apr;193(4):499-505.
The changes in serum total CPK and its isoenzymes have not been delineated in acute mesenteric infarction. As measurement of serum CPK levels could conceivably be a useful diagnostic test for bowel infarction, this experiment was performed to assess changes in serum CPK levels in bowel infarction in dogs, using sham operation and talc peritonitis as controls. Laparotomies were performed in 20 dogs, and each was as signed randomly to one of three groups: those having laparotomy (LAP), talc peritonitis (PER), and superior mesenteric artery infarction (MAI). Mixed venous blood samples were obtained from all subjects for 30 hours after surgery. All animals were killed, and complete autopsies were performed. Confirmation of infarction and determination of its extent were obtained through both gross and microscopic examination of the gut in canines subjected to arterial infarction. Total serum CPK levels were determined by spectrophotometric analysis. Agarose gel electrophoresis was used to determine the levels of each of the isoenzymes. Significant elevations of CPK and CPK-MM occurred nine hours after injury. CPK-BB reached maximum elevation by six hours, while CPK-MB did not reach its maximum until 24 hours after injury. From data in the study we conclude that total CPK and its isoenzymes become elevated in the serum of canines subjected to experimental superior mesenteric artery infarction. That CPK-BB elevations peak in the first 12 hours after injury and CPK-MB in the second 12 hours after injury may be of particular diagnostic significance.
急性肠系膜梗死时血清总肌酸磷酸激酶(CPK)及其同工酶的变化尚未明确。鉴于测定血清CPK水平可能是诊断肠梗死的一项有用检测方法,本实验通过以假手术和滑石粉性腹膜炎作为对照,来评估犬肠梗死时血清CPK水平的变化。对20只犬进行剖腹手术,每只犬随机分为三组之一:接受剖腹手术组(LAP)、滑石粉性腹膜炎组(PER)和肠系膜上动脉梗死组(MAI)。术后30小时从所有受试对象采集混合静脉血样本。所有动物均处死后进行完整尸检。通过对动脉梗死犬的肠道进行大体和显微镜检查来确认梗死并确定其范围。采用分光光度分析法测定血清总CPK水平。用琼脂糖凝胶电泳法测定各同工酶水平。损伤后9小时CPK和CPK-MM显著升高。CPK-BB在6小时时达到最大升高,而CPK-MB直到损伤后24小时才达到最大值。根据本研究的数据,我们得出结论,在实验性肠系膜上动脉梗死的犬血清中,总CPK及其同工酶升高。CPK-BB在损伤后最初12小时内升高达到峰值,CPK-MB在损伤后第二个12小时内升高达到峰值,这可能具有特殊的诊断意义。