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

摘要： 背景　急性肠系膜上静脉血栓形成在临床上并不少见，血栓形成后，可导致肠道缺血、肠系膜坏死，进一步可发展为严重腹腔感染，最终造成患者死亡。由于该病早期临床症状并不典型，因此，目前对于该病的早期诊断仍较困难。目的　探讨D-二聚体、肠脂肪酸结合蛋白水平对急性肠系膜上静脉血栓形成患者早期诊断的临床意义。方法　收集2015年1月—2016年12月云南省第二人民医院收治的急性腹痛伴便隐血阳性的患者376例，经腹部超声、腹部增强CT、造影和腹腔穿刺等检查最后确诊为急性肠系膜上静脉血栓形成患者21例（观察组），其余355例为对照组。观察两组患者不同时间点（0、6、12、24、48 h）D-二聚体、肠脂肪酸结合蛋白水平。分析不同临床特征急性肠系膜上静脉血栓形成患者D-二聚体、肠脂肪酸结合蛋白水平。结果　不同时间点观察组D-二聚体、肠脂肪酸结合蛋白均高于对照组（P<0.05）。入院时D-二聚体、肠脂肪酸结合蛋白诊断急性肠系膜上静脉血栓形成的受试者工作特征曲线（ROC曲线）下面积分别为0.916〔95%CI（0.831，1.000），P<0.001〕和0.823〔95%CI（0.691，0.955），P<0.001〕。合并肠道坏死、腹腔感染、脓毒症、广泛性血栓和急性生理学与慢性健康状况评分系统Ⅱ（APPACHEⅡ）评分≥10分的重型急性肠系膜上静脉血栓形成患者D-二聚体、肠脂肪酸结合蛋白水平高于仅有腹痛伴便隐血阳性的轻症患者（P<0.05）。结论　D-二聚体、肠脂肪酸结合蛋白水平在急性肠系膜上静脉血栓形成患者中异常升高，可能与病情严重程度相关，可作为早期诊断该病的重要指标之一。

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