INTESTINAL ALKALINE PHOSPHATASE ISOENZYME IN THE DIAGNOSIS OF ABDOMINAL SURGICAL PATHOLOGY

The purpose of the study: to compare changes in the spectra of total and intestinal isoforms of alkaline phosphatase in blood serum and fecal suspension in patients with urgent diseases, the most significant for abdominal surgery.
Materials and methods. In samples of blood serum and fecal emulsion of patients with acute appendicitis, acute intestinal obstruction, perforated ulcer and strangulated hernia, the activity of the enzyme alkaline phosphatase (ALP) and its intestinal isoenzyme (IAP) was studied.
Research results. It has been established that the activity of IAP in blood serum in patients with uncomplicated forms of OA increases to 4 U / l, and in the fecal emulsion it is 5 mU/g of feces. With phlegmonous OA, the activity of APCF is 7 U / l and 10 mU / g of feces, and the ratio of IAP / ALP is 2.5%, with gangrenous - 9 U / l, 12 IU / g of feces and the ratio is 2.8%, and with perforated-gangrenous OA with the development of widespread purulent peritonitis, the levels of IAP in serum are 12 U/l, in feces 16 mU/g and the ratio is 3.0%. In acute small bowel obstruction, the levels of IAP in serum are 12 U/l, in feces 21 mU/g and the ratio of IAP /AP is 3.3%. In colonic obstruction, including acute colonic obstruction of tumor origin 11 U/l, 16 mU/g and 3.6%. The maximum values of IAP in serum, 6 times higher than in the comparison group, are characteristic of appendicular peritonitis and all variants of acute intestinal obstruction. And the maximum values of IAP in the fecal emulsion, almost 6.5 times higher than in the comparison group, are characteristic of strangulation small bowel obstruction.
Conclusion. On the basis of the obtained results, it was concluded that the maximum values of IAP more than 21 mU/g of feces and the ratio of IAP / ALP of 3.6% are typical only for small bowel obstruction, and the test for IAP may be important in acute abdominal surgical pathology.

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