关键词: 静脉血栓形成, 肠系膜, 急性病, D-二聚体, 肠脂肪酸结合蛋白, 诊断

Abstract: Background　Acute superior mesenteric vein thrombosis is not uncommon in clinical practice.Thromboses can lead to intestinal ischemia and mesenteric necrosis，which can further develop into a severe abdominal infection and eventually cause death.Because the early clinical symptoms of acute superior mesenteric vein thrombosis are not typical，its early diagnosis is difficult.Objective　To investigate the clinical significance of D-dimer and intestinal fatty acid binding protein in the early diagnosis of acute superior mesenteric vein thrombosis.Methods　From January 2015 to December 2016，376 patients with acute abdominal pain and occult blood positive in the Second People's Hospital of Yunnan Province were collected.A total of 21 patients with acute superior mesenteric vein thrombosis diagnosed by abdominal ultrasound，abdominal enhanced CT，angiography and abdominal puncture were classified as the observation group，and the remaining 355 patients were classified as the control group.The D-dimer and intestinal fatty acid binding protein levels were observed at different time points（0，6，12，24，48 h） in the two groups and different clinical features of patients with acute superior mesenteric vein thrombosis were analyzed corresponding to their D-dimer and intestinal fatty acid binding protein levels.Results　At different time points，the levels of D-dimer and intestinal fatty acid binding protein of patients in the observation group were higher than those of patients in the control group（P<0.05）．At admission，the area under the receiver operating characteristic（ROC） curve of D-dimer and intestinal fatty acid binding protein levels in the diagnosis of acute superior mesenteric vein thrombosis were 0.916〔95%CI（0.831，1.000），P<0.001〕and 0.823〔95%CI（0.691，0.955），P<0.001〕respectively.The D-dimer and intestinal fatty acid binding protein levels of patients with severe acute mesenteric vein thrombosis complicated with intestinal necrosis，abdominal infection，sepsis，extensive thrombosis and Acute Physiology and Chronic Health EvaluationⅡ（APACHEⅡ） ≥10 were higher than those of patients with only abdominal pain and occult blood positive（P<0.05）．Conclusion　The D-dimer and intestinal fatty acid binding protein in patients with acute superior mesenteric vein thrombosis were abnormally increased，which may be related to the severity of acute superior mesenteric vein thrombosis and can be used as an important indicator for its early diagnosis.

Key words: Venous thrombosis, Mesentery, Acute disease, D-dimer, Intestinal fatty acid binding protein, Diagnosis