Watari M, Murakami H, Orihashi K, Sueda T, Matsuura Y, Kajihara H
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Hiroshima J Med Sci. 1997 Dec;46(4):159-67.
Superior mesenteric artery occlusion (SMAO) is often fatal. An indicator which enables the early diagnosis of SMAO is needed. As we think putrefaction products must appear and increase in the blood and ascites in SMAO, changes in the concentrations of ammonia, one of the putrefaction products, were measured in this study. Thirteen adult mongrel dogs were used for the in vitro experiment. The jejunum, ileum, and ascending colon were resected and incubated in saline. Changes in ammonia concentrations in the saline were examined at various incubation times. In the in vivo experiment, 11 mongrel dogs comprised the SMAO group and another 10 mongrel dogs comprised the control group. Changes in ammonia concentrations in the blood and ascites were examined in both groups. In the in vitro experiment, ammonia concentrations in the saline bath increased in all samples. It was highest in the sample from around the ascending colon, and lowest from around the jejunum. However, at the end of experiment, this difference became insignificant. In the in vivo experiment, ammonia concentrations in samples of the blood increased early and significantly in the SMAO group, compared with the control group. Ammonia concentrations in samples of the ascites also increased significantly. The in vitro experiment showed that ammonia leaked from the ischemic intestines, and secondarily, a large amount of ammonia was produced from intestinal putrefaction. The in vivo experiment revealed that the ammonia level in the blood could be used as a good early indicator of acute mesenteric ischemia.
肠系膜上动脉闭塞（SMAO）通常是致命的。需要一种能够早期诊断SMAO的指标。由于我们认为腐败产物一定会在SMAO患者的血液和腹水中出现并增加，因此在本研究中测量了腐败产物之一——氨浓度的变化。13只成年杂种犬用于体外实验。切除空肠、回肠和升结肠并在盐水中孵育。在不同的孵育时间检查盐水中氨浓度的变化。在体内实验中，11只杂种犬组成SMAO组，另外10只杂种犬组成对照组。检查两组血液和腹水中氨浓度的变化。在体外实验中，所有样本盐浴中的氨浓度均升高。升结肠周围样本中的氨浓度最高，空肠周围样本中的氨浓度最低。然而，在实验结束时，这种差异变得不显著。在体内实验中，与对照组相比，SMAO组血液样本中的氨浓度早期显著升高。腹水样本中的氨浓度也显著升高。体外实验表明，氨从缺血肠中泄漏，其次，肠道腐败产生大量氨。体内实验表明，血液中的氨水平可作为急性肠系膜缺血的良好早期指标。
