急性肠系膜缺血的生物标志物研究进展

doi:10.16138/j.1673-6087.2026.02.15

摘要/Abstract

摘要：

急性肠系膜缺血（acute mesenteric ischemia, AMI）是一种病死率极高的临床急症，早期诊断和预后评估对改善患者临床结局至关重要。本文综述了多种生物标志物在AMI诊断及预后评估中的研究进展。白细胞计数、C反应蛋白、降钙素原等检测便捷、成本低，适合初筛，但特异性有限。α-谷胱甘肽S-转移酶（α-glutathione S-transferase, α-GST）及肠脂肪酸结合蛋白（intestinal fatty acid-binding protein, I-FABP）等在特异性方面更具优势，适用于需鉴别诊断的患者。此外，组合炎症指数，如中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值，因获取便捷而具有良好的推广前景。系统评分如急性生理学和慢性健康评估Ⅱ（acute physiology and chronic health evaluation Ⅱ, APACHE Ⅱ）、序贯器官衰竭评估（sequential organ failure assessment, SOFA）适用于合并多器官功能衰竭的患者。前列腺素E主要尿代谢物（prostaglandin E-major urinary metabolite, PGE-MUM）、低氧诱导因子1α（hypoxia-inducible factor 1 alpha, HIF-1α）等新兴标志物具有一定的潜在价值，但尚需进一步验证。目前各类标志物均存在样本量不足、缺乏前瞻性研究等局限性，未来亟需开展大规模、多中心的高质量研究，以进一步验证多种标志物的临床应用价值。

关键词: 急性肠系膜缺血, 生物标志物, 预后评估, 组合炎症指数, 肠脂肪酸结合蛋白

Abstract:

Acute mesenteric ischemia (AMI) is a critical clinical emergency with an extremely high mortality rate. Early diagnosis and prognosis assessment are essential for improving patient outcomes. This article reviews the research progress on various biomarkers in the diagnosis and prognostic evaluation of AMI. Biomarkers such as white blood cell count, C-reactive protein and procalcitonin are convenient and low-cost tests suitable for initial screening, but they have limited specificity. α-glutathione S-transferase (α-GST), intestinal fatty acid-binding protein (I-FABP) and others have advantages in specificity and are suitable for patients requiring differential diagnosis. In addition, combined inflammatory indices, including the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, are easily obtainable and have good potential for clinical application. Systemic scoring systems, such as the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA), are applicable to patients with multiple organ dysfunction syndrome. Emerging biomarkers, including prostaglandin E-major urinary metabolite (PGE-MUM) and hypoxia-inducible factor 1 alpha (HIF-1α), have certain potential value but require further validation. At present, various biomarkers are limited by small sample sizes and a lack of prospective studies. Large-scale, multi-center, high-quality studies are urgently needed to further validate the clinical application value of multiple biomarkers.

Key words: acute mesenteric ischemia, biomarkers, prognosis assessment, combined inflammation index, intestinal fatty acid-binding protein

邵丙强, 吴友伟. 急性肠系膜缺血的生物标志物研究进展[J]. 内科理论与实践, 2026, 21(02): 194-198.

SHAO Bingqiang, WU Youwei. Research progress on biomarkers of acute mesenteric ischemia[J]. Journal of Internal Medicine Concepts & Practice, 2026, 21(02): 194-198.

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