肠型脂肪酸结合蛋白检测在足月新生儿坏死性小肠炎中的临床意义

皇甫春荣; 李平; 田云粉

doi:10.7499/j.issn.1008-8830.2014.11.011

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中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (11) : 1125-1128. DOI: 10.7499/j.issn.1008-8830.2014.11.011

论著·临床研究

肠型脂肪酸结合蛋白检测在足月新生儿坏死性小肠炎中的临床意义

皇甫春荣, 李平, 田云粉

作者信息 +

Clinical significance of serum intestinal fatty acid-binding protein in full-term infants with necrotizing enterocolitis

HUANG-FU Chun-Rong, LI Ping, TIAN Yun-Fen

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文章历史 +

摘要

目的探讨肠型脂肪酸结合蛋白(I-FABP)在足月新生儿坏死性小肠炎(NEC)中的临床应用价值.方法 2012 年2 月至2014 年1 月确诊为NEC 的41 例足月新生儿为病例组,其中Ⅰ期患儿24 例,Ⅱ ~ Ⅲ期患儿17 例;同期确诊为非消化系统疾病的62 例患儿为对照组.采用酶联免疫吸附法(ELISA)检测各组患儿血清I-FABP 和C 反应蛋白(CRP)水平.采用受试者工作特征曲线(ROC)对I-FABP 诊断NEC 进行评估.结果病例组不同分级患儿血清I-FABP 水平均显著高于对照组(均P<0.05),且Ⅱ ~ Ⅲ期组显著高于Ⅰ期患儿(P<0.05); I-FABP 血清标志物 ROC 曲线下面积(AUC)为0.85(95%CI:0.78~0.92),最佳诊断截点值为2.25 ng/mL,该截点值下诊断NEC 的敏感性为80.49%,特异性为70.19%.病例组与对照组患儿血清CRP 水平差异无统计学意义(P>0.05).结论血清I-FABP 在NEC 患儿早期(Ⅰ期)已显著升高,并与病情严重程度存在相关性,可作为诊断NEC 的参考指标.

Abstract

Objective To evaluate the clinical value of intestinal fatty acid-binding protein (Ⅰ-FABP) in full-termnew born infants with necrotizing enterocolitis (NEC). Methods Forty-one full-term infants with a confirmed diagnosisof NEC from February 2012 to January 2014 were recruited as case group (stage I:24 cases; stage Ⅱ-Ⅲ:17 cases).Sixty-two children diagnosed with non-digestive diseases in the same period were recruited as the control group. Serumlevels of Ⅰ-FABP and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay. The diagnosticvalue of I-FABP for NEC was assessed using the receiver operating characteristic (ROC) curve. Results Stage Ⅰ andstage Ⅱ-Ⅲ cases in the case group had significantly higher serum Ⅰ-FABP levels than the control group (P<0.05), andstage Ⅱ-Ⅲ cases had significantly higher serum Ⅰ-FABP levels than stage Ⅰ cases (P<0.05). The area under the ROCcurve for serum Ⅰ-FABP was 0.85 (95% CI:0.78-0.92), with the optimal cut-off point of 2.25 ng/mL. Under this cut-offpoint, the sensitivity and specificity were 80.49% and 70.19%, respectively. There was no significant difference in serum CRP level between the case and control groups (P>0.05). Conclusions In newborn infants with NEC, serum I-FABPlevel increases significantly in stage I, and it is correlated with the disease severity. Therefore, serum I-FABP can beused as a biomarker for the diagnosis of NEC.

导出引用

皇甫春荣, 李平, 田云粉. 肠型脂肪酸结合蛋白检测在足月新生儿坏死性小肠炎中的临床意义[J]. 中国当代儿科杂志. 2014, 16(11): 1125-1128 https://doi.org/10.7499/j.issn.1008-8830.2014.11.011

HUANG-FU Chun-Rong, LI Ping, TIAN Yun-Fen. Clinical significance of serum intestinal fatty acid-binding protein in full-term infants with necrotizing enterocolitis[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(11): 1125-1128 https://doi.org/10.7499/j.issn.1008-8830.2014.11.011

参考文献

[1] 王雪莲, 陈超. 新生儿坏死性小肠结肠炎的病因及危险因素研究进展[J]. 中华儿科杂志, 2013, 51(5):340-344.
[2] 王会苹, 张宽. 新生儿坏死性小肠结肠炎早期X 线表现分析[J]. 实用医学杂志, 2011, 27(3):455-456.
[3] 秦嘉丽. 新生儿坏死性小肠结肠炎诊断进展[J]. 重庆医学, 2012, 41(19):1991-1993.
[4] 余珍珠, 黄惠君, 刘晓红, 等. 新生儿坏死性小肠结肠炎80 例临床分析[J]. 中华围产医学杂志, 2014, 17(1):55-57.
[5] 秦嘉丽, 韦红, 李禄全, 等. 血清肠型脂肪酸结合蛋白在诊断新生儿坏死性小肠结肠炎中的意义[J]. 中华小儿外科杂志, 2013, 34(8):590-594.
[6] Walsh MC, Kliegman RM, Fanaroff AA. Necrotizing enterocolitis:a practitioner's perspective[J]. Pediatr Rev, 1988, 9(7):219-226.
[7] De Plaen IG. Inflammatory signaling in necrotizing enterocolitis[J]. Clin Perinatol, 2013, 40(1):109-124.
[8] Moore JE. Newer monitoring techniques to determine the risk of necrotizing enterocolitis[J]. Clin Perinatol, 2013, 40(1):125-134.
[9] 李晶, 周伟. 新生儿坏死性小肠结肠炎的生物标志物研究进展[J]. 中华围产医学杂志, 2014, 17(2):135-139.
[10] 马少春, 阿爽. C 反应蛋白测定在坏死性小肠结肠炎中的应用[J]. 中国误诊学杂志, 2009, 9(1):58-59.
[11] Reisinger KW, Kramer BW, Van der Zee DC, et al. Non-invasive serum amyloid A (SAA) measurement and plasma platelets for accurate prediction of surgical intervention in severe necrotizing enterocolitis (NEC)[J]. PLoS One, 2014, 9(3):e90834.
[12] 赵海东, 田晓峰, 郭健, 等. 肠型脂肪酸结合蛋白对肠缺血早期诊断的意义[J]. 中国普通外科杂志, 2004, 13(7):513-516.
[13] 王家胜, 杨强. 肠型脂肪酸结合蛋白研究进展[J]. 世界科技研究与发展, 2012, 34(4):611-612, 620.
[14] 傅益永, 韦红. 肠型脂肪酸结合蛋白在早期诊断小儿肠缺血性疾病中的研究进展[J]. 实用儿科临床杂志, 2011, 26(19):1531-1533.
[15] Thuijls G, Derikx JP, van Wijck K, et al. Non-invasive markers for early diagnosis and determination of the severity of necrotizing enterocolitis[J]. Ann Surg, 2010, 251(6):1174-1180.
[16] Swets JA. ROC analysis applied to the evaluation of medical imaging techniques[J]. Invest Radiol, 1979, 14(2):109-121.
[17] 王祖芳, 李桂军. ROC 曲线分析卵泡刺激素及黄体生成素辅助诊断女童性早熟的价值[J]. 中国当代儿科杂志, 2012, 14(6):441-444.