用激光多普勒评估实验性肠系膜缺血模型中的肠坏死情况

Nurullah Aksoy, Davut Sinan Kaplan, Mustafa Orkmez, Ömer Eronat
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摘要

背景:在美国和欧洲,急性肠系膜缺血(AMI)是千分之一急诊入院患者的病因,发病率和死亡率都很高。目前的诊断和治疗方法达不到预期效果,常常导致诊断延迟,以及在治疗过程中难以检测到缺血的肠道组织。本研究评估了临床上常用的生化指标--肌酸激酶、C 反应蛋白 (CRP) 和乳酸脱氢酶 (LDH)--的诊断价值,以及在实验性肠系膜缺血大鼠模型中使用激光多普勒测量血流的诊断价值。我们还将这些指标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。方法:将大鼠分为五组:对照组、1 小时组、2 小时组、3 小时组和 4 小时组,每组诱导肠系膜缺血相应的时间。之后,我们使用激光多普勒测量血流量。我们还采集了血液样本和肠道活检样本,用于生化参数分析。这些数值与肠道存活率之间的关系使用Chiu缺血评分系统进行评估:结果:用激光多普勒测量血流与肠缺血的持续时间和严重程度相关。CRP 水平与缺血时间长短无明显关系。然而,肌酸激酶和乳酸脱氢酶(LDH)水平在缺血持续到第三和第四小时时明显升高:结论: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)患者的有用生物标志物。使用激光多普勒测量血流可在手术中准确识别需要切除的肠环路。
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Evaluation of intestinal necrosis with laser Doppler in experimental mesenteric ischemia model.

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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