肠脂肪酸结合蛋白在急腹症患者中鉴别急性肠缺血的价值  

The value of serum intestinal fatty acid binding protein measurement in discriminating intestinal ischemia in patients with acute abdomen

作　　者：石卉[1] 吴本俨[1] 刘文徽[1] 苏斌斌[1] 李婷婷[1] 

机构地区：[1]解放军总医院南楼消化内科,北京100853

出　　处：《中华内科杂志》2012年第9期690-693,共4页Chinese Journal of Internal Medicine

基　　金：中央保健专项资金科研课题（B2009A105）

摘　　要：目的评估肠脂肪酸结合蛋白（I-FABP）在急腹症患者中鉴别急性肠缺血的价值。方法2009年11月至2011年8月解放军总医院151例住院急腹症患者及17例健康对照者纳入本研究，测定其血清I-FABP水平，根据ROC曲线计算I-FABP诊断急性肠缺血的临界值、敏感性、特异性、阳性似然比、阴性似然比、阳性预测值、阴性预测值，评估其诊断及鉴别诊断价值。结果151例急腹症患者中急性肠缺血24例，非肠缺血127例。肠缺血组的I-FABP水平[（109．67±48．82）μg/L]明显高于非肠缺血组[（36．78±11．25）μg/L]和健康对照组[（8．33±6．25）μg/L]，P值均〈0．01。I-FABP的诊断临界值为87．52μg/L，I-FABP诊断急性肠缺血的敏感度为0．762，阴性预测值为0．963，阳性似然比3．05，阴性似然比0．24。结论血清I-FABP用于鉴别急腹症中急性肠缺血患者具有临床诊断价值。Objective To assess the differential diagnostic value of serum intestinal fatty acid binding protein （I-FABP） in distinguishing intestinal isehemia patients from acute abdomen patients. Methods A total of 151 patients with acute abdomen and 17 healthy controls from the PLA General Hospital were enrolled from November, 2009 to August, 2011. Serum I-FABP levels were measured by ELISA. According to the ROC curve, the cut-off value, sensitivity, specificity, positive likelihood ratio （PLR）, negative likelihood ratio （NLR）, positive predictive value （PPV） and negative predictive value （NPV） were calculated. Results Of the 151 acute abdomen patients, there were 24 intestinal ischemia patients and 127 without intestinal ischemia. Serum I-FABP level in intestinal ischemia group [ （ 109.67 ±48.82）μg/L] was significantly higher than those in patients without intestinal isehemia [ （36. 78 ± 11.25 ） ）μg/L ] and healthy controls [ （ 8.33 ± 6.25 ） ）μg/L] （ all P values 〈 0. 01 ）. The serum I-FABP cut-off value for the diagnosis of intestinal ischemia was 87.52）μg/L. Serum I-FABP was efficient in terms of sensitivity （0.762）, NPV （0.963）, PLR （3.05） and NLR （0.24） in the diagnosis of intestinal ischemia. Conclusion I-FABP is potentially useful for discriminating intestinal ischemia from acute abdomen.

关 键 词：急腹症 诊断 鉴别 肠缺血 肠脂肪酸结合蛋白 

分 类 号：R656.1[医药卫生—急诊医学]