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  

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

作　　者：皇甫春荣[1] 李平[1] 田云粉[1] 

机构地区：[1]云南省第一人民医院儿科,云南昆明650034

出　　处：《中国当代儿科杂志》2014年第11期1125-1128,共4页Chinese Journal of Contemporary Pediatrics

基　　金：云南省应用基础研究计划项目(2012FB204)

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。Objective To evaluate the clinical value of intestinal fatty acid-binding protein （I-FABP） in full-term newborn infants with necrotizing enterocolitis （NEC）. Methods Forty-one full-term infants with a conifrmed diagnosis of 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. Serum levels of I-FABP and C-reactive protein （CRP） were determined by enzyme-linked immunosorbent assay. The diagnostic value of I-FABP for NEC was assessed using the receiver operating characteristic （ROC） curve. Results Stage I and stage II-III cases in the case group had signiifcantly higher serum I-FABP levels than the control group （P〈0.05）, and stage II-III cases had signiifcantly higher serum I-FABP levels than stage I cases （P〈0.05）. The area under the ROC curve 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-off point, the sensitivity and speciifcity were 80.49%and 70.19%, respectively. There was no signiifcant difference in serum CRP level between the case and control groups （P〉0.05）. Conclusions In newborn infants with NEC, serum I-FABP level increases signiifcantly in stage I , and it is correlated with the disease severity. Therefore, serum I-FABP can be used as a biomarker for the diagnosis of NEC.

关 键 词：肠型脂肪酸结合蛋白 坏死性小肠炎 新生儿 

分 类 号：R722.1[医药卫生—儿科]