Lange H, Jäckel R
Surgical Department Hospital, Köping, Sweden.
Eur J Surg. 1994 Jun-Jul;160(6-7):381-4.
To verify the diagnostic importance of the plasma lactate concentration in acute abdominal disease and to examine its role as a marker of mesenteric ischaemia.
Prospective study.
Two departments of surgery, one in Sweden and one in Germany.
85 patients with acute abdominal symptoms.
Correlation between the plasma lactate concentration before operation or (in the case of those not operated on) before the diagnosis was established, and the final diagnosis.
Plasma lactate concentrations exceeded the reference range in all cases of mesenteric ischaemia (n = 20) and general bacterial peritonitis (n = 15) and in half of the 20 cases of intestinal obstruction. They were also raised in 3 of 10 cases of acute pancreatitis.
A raised plasma lactate concentration is always a sign of an acute life-threatening condition, and usually indicates the need for an emergency operation. As a marker of mesenteric ischaemia its sensitivity was 100% and its specificity 42%. We conclude that a raised serum lactate concentration is the best marker of mesenteric ischaemia to date.
验证血浆乳酸浓度在急性腹部疾病诊断中的重要性，并探讨其作为肠系膜缺血标志物的作用。
前瞻性研究。
瑞典和德国的两个外科科室。
85例有急性腹部症状的患者。
手术前或（对于未接受手术的患者）确诊前的血浆乳酸浓度与最终诊断之间的相关性。
在所有肠系膜缺血病例（n = 20）、一般性细菌性腹膜炎病例（n = 15）以及20例肠梗阻病例中的半数中，血浆乳酸浓度超过参考范围。在10例急性胰腺炎病例中的3例中，血浆乳酸浓度也升高。
血浆乳酸浓度升高始终是急性危及生命状况的标志，通常表明需要进行急诊手术。作为肠系膜缺血的标志物，其敏感性为100%，特异性为42%。我们得出结论，血浆乳酸浓度升高是迄今为止肠系膜缺血的最佳标志物。
