Role Of D-lactate, LDH And Hb In Early Diagnosis Of Acute Mesenteric Ischemia

Acute mesenteric ischemia secondary to arterial embolus, artery thrombosis and venous thrombosis is a serious vascular emergency. Such severe ischemia manifests as swift advance, intestinal gangrene or shock in short time. Despite advances in understanding of AMI, the mortality rate remains high, ranged at 60% and 80%. The prognosis of AMI depends on early diagnosis and rapid treatment. So, early diagnosis and prompt effective treatment are essential to improve the clinical outcome. Acute mesenteric ischemia frequently presents a diagnostic dilemma to vascular surgeon since the symptoms and signs are nonspecific,and there are no specific laboratory tests for AMI. The aim of this experimental study was to identify a biochemical marker for the diagnosis of AMI by investigating the changes of D-lactate, Lactate dehydrogenase( LDH) and Hemoglobin (Hb) in acute mesenteric ischemia of rabbits.[Objectve]: The aim of this experimental study was to investigate the change of D-lactate, LDH and Hb in acute mesenteric ischemia in rabbits caused by ligation of superior mesenteric artery, and evaluate their diagnostic value as an early indicator in acute mesenteric ischemia.[Methods]: Twenty New Zealand White rabbits, weighting 2.0 to 3.0kg, were divided into two groups of 10 animals each. After appropriate anesthesia, experimental animals underwent a standard midline laparotomy with ligation of the superior mesenteric artery at its aortic off. Animals served as controls underwent sham laparotomy with exposure of the superior mesenteric artery (SMA) at its aortic take off. Serum samples were obtained from femoral vein at pre-operation, 2h, 4h, and 6h after operation. All blood samples were allowed to be preserved at -30°C and the serum removed by centrifugation, for detecting the activity of D-lactate, LDH and Hb. Tissue were taken from intestine before and at 2h, 4h, 6h after operation, placed in 10% formalin, reviewed by a histopathologist.[Results]: Intestinal ischemia was noted with worsening grades of injury observed with greater ligation times. The serum levels of D-lactate after operation significantly increased with increasing ischemia time, p<0.05.Plasma LDH activity of the ligated group were high 2h after operation, but it was until 4h after operation that plasma LDH levels were significantly increased. The levels of Hb elevated at 2h after operation, p<0.05;but after that, it had a decreased tendency.[Conclusions]: D-lactate is a sensitive marker in the early diagnosis of mesenteric ischemia. LDH is helpful in early diagnosis of acute mesenteric ischemia. The role of Hb in diagnosis of AMI remains to be further researched.