肠脂肪酸结合蛋白在外伤性肠破裂早期诊断中的应用研究  

Application of intestinal fatty acid binding protein in early diagnosis of traumatic intestinal rupture

作　　者：田锐[1] 王瑞兰[1] 钱永兵[1] 胡家昌[1] 谢晖[1] 陆健[1] 周志刚[1] 赵奇[1] 俞康龙[1] 

机构地区：[1]上海交通大学附属第一人民医院危重病科,201620

出　　处：《中华创伤杂志》2012年第4期312-315,共4页Chinese Journal of Trauma

基　　金：上海市科委医学引导资助项目（11411962900）

摘　　要：目的探讨肠脂肪酸结合蛋白（intestinalfattyacidbindingprotein，IFABP）在急性外伤性肠破裂早期诊断中的应用。方法选择2010年7月-2011年6月急诊接诊的疑似急性外伤性肠破裂的患者，在人院当时、入院后1，2，3，4，6，8，12，16，24，48h留取血标本。同时对患者按现有诊疗常规急诊密切观察、治疗，随访临床体征及影像学，确诊为肠破裂者行手术治疗并记录入院至确诊时间。血标本以ELISA法进行IFABP测定。根据最终诊断结果，将患者分为肠破裂组及非肠破裂组。检测血IFABP变化情况及各时相点两组患者间血IFABP浓度值差异。结果共纳人患者33例，其中肠破裂组11例，非肠破裂组22例。肠破裂组患者入院至确诊时间为（7．0±2．0）h。在前述各检测时相点，肠破裂组患者的血IFABP浓度值均显著高于非肠破裂组患者（P〈0．05）。在肠破裂组患者，血IFABP浓度自人院时即开始升高，人院后1h开始达到峰值，并维持至确诊肠破裂而手术。在非肠破裂组患者，血IFABP浓度在入院后至入院24h内比较稳定，无明显波动。结论血IFABP是急性外伤性肠破裂的早期诊断指标。Objective To investigate the role of intestinal fatty acid binding protein （IFABP） in early diagnosis of acute traumatic intestinal rupture. Methods The patients with suspected acute trau- matic intestinal rupture admitted in our emergency department from July 2010 to June 2011 were involved in the study. Their blood samples were taken on admission, 1,2,3,4,6,8,12,16,24 and 48 hours after admission. All the patients were given closely medical observation and therapy, and were followed up in aspects of their clinical signs and imageology according to the present diagnosis and treatment routine. Surgical procedures would be carried out as soon as the diagnosis of intestinal rupture was confirmed and the duration between the admission and the final diagnosis was recorded. All the blood samples were de- termined for the IFABP concentration by means of ELISA. According to the final diagnosis results, the patients were divided into the intestinal rupture group and non-intestinal rupture group. The changes of IFABP concentration and its concentration difference between the two groups at different time points were compared. Results The study involved 33 patients, including 11 patients with confirmed intestinal rupture （ intestinal rapture group） and 22 without intestinal rupture （ non-intestinal rupture group）. The average duration from hospitalization to the final diagnosis in the intestinal rapture group was （7.0 ＋ 2.0） hours. At all the given time points, the IFABP concentration in the intestinal rupture group was sig- nificantly higher than that in the non-intestinal rupture group （ P 〈 0.05 ）. The IFABP concentration in the intestinal rupture group was ascended on admission, reached the peak one hour later and maintained the level till the surgery, while the IFABP concentration was relatively stable in the non-intestinal rupture group within 24 hours after admission. Conclusion IFABP is the index for early diagnosis of acute traumatic intestinal rupture.

关 键 词：肠破裂 脂肪酸结合蛋白质类 早期诊断 

分 类 号：R656.7[医药卫生—外科学]