IFABP及D-乳酸对急性肠梗阻患者病情严重程度及预后的指导价值  

Value of IFABP and D-Lactate in Guiding the Severity of Diseases and Prognosis of Patients with Acute Ileus

作　　者：霍玲玲 孙昭睿 HUO Ling-ling;SUN Zhao-rui(Digestive System Department, Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 222000 China;ICU, Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 222000 China)

机构地区：[1]南京中医药大学连云港附属医院消化内科,江苏南京222000 [2]南京中医药大学连云港附属医院重症医学科,江苏南京222000

出　　处：《系统医学》2018年第2期63-65,68,共4页Systems Medicine

摘　　要：目的探讨肠脂肪酸结合蛋白(IFABP)及D-乳酸对急性肠梗阻患者的病情严重程度及预后的指导价值,为急性肠梗阻尤其是绞窄性肠梗阻的早期诊治提供血液学检查特异性指标及实验依据。方法选择2016年7月—2017年6月该院急性肠梗阻患者60例为观察组,并纳入同期健康体检者60名为对照组,检测并比较两组受试者血液中IFABP及D-乳酸水平,并观察IFABP及D-乳酸水平与观察组患者疾病严重程度及预后的关系。结果观察组入院1 hIFABP为(982.34±86.77)ng/mL、D-乳酸水平为(326.19±110.85)μg/L,明显高于对照组的(160.76±75.82)ng/mL、(218.46±65.17)μg/L,差异有统计学意义(t_(1 hIFABP)=55.23,t_(1 hD-乳酸)=6.49,P<0.05);入院时,观察组中绞窄性肠梗阻患者血清IFABP为(1 538.02±142.13)ng/mL,D-乳酸水平为(415.31±130.97)μg/L,均显著高于单纯性肠梗阻患者的(736.12±72.68)ng/mL、(283.52±102.92)μg/L,差异有统计学意义(t_(IFABP)=27.51,t_(D-乳酸)=4.33,P<0.05);入院6 h后,经治疗观察组单纯性肠梗阻及绞窄性刚梗阻患者血清IFABP为(212.06±68.83)ng/mL及(210.98±70.21)ng/mL,D-乳酸分别为(234.61±64.05)μg/L、(235.86±64.57)μg/L,均较入院1 h时降低,差异有统计学意义(t_(单IFABP)=28.67,t_(单D-乳酸)=2.21,t_(绞IFABP)=45.85,t_(绞D-乳酸)=6.73,P<0.05),但观察组两种疾病类型之间差异无统计学意义(t_(6 hIFABP=0.06),t_(6 hD-乳酸)=0.07,P>0.05);血清IFABP及D-乳酸用于诊断急性肠梗阻患者粘膜损伤的AUC分别为0.808和0.875,最佳临界值分别为843.96ng/mL和335.37μg/L。结论血清IFABP及D-乳酸在急性肠梗阻的诊断中参考价值较高,且对患者预后具有较高的临床指导价值。Objective To study the value of IFABP and D-Lactate in guiding the severity of diseases and prognosis of patients with acute ileus thus providing the hematological examination specificity indicators for the early diagnosis and treatment of acute ileus especially the strangulated intestinal obstruction.Methods 60 cases of patients with acute ileus in our hospital from July 2016 to June 2017 were selected as the observation group,60 cases of healthy physical examination people at the same period were selected as the control group,and the levels of IFABP and D-Lactate were tested and the correlation between the IFABP and D-Lactate and severity of diseases and prognosis of patients with acute ileus was observed.Results The IFABP and D-Lactate levels at 1h after admission in the observation group were obvi-ously higher than those in the control group[（982.34±86.77）ng/mL,（326.19±110.85）μg/L vs（160.76±75.82）ng/mL,（218.46±65.17）μg/L],and the differences were statistically significant（t1 hIFABP=55.23,t1 h D-Lactate=6.49,P〈0.05）;at admission,the serum IFABP and D-Lactate level of patients with strangulated intestinal obstruction were obviously higher than those of patients with simple intestinal obstruction in the observation group[（1 538.02±142.13）ng/mL,（415.31±130.97）μg/Lvs（736.12±72.68）ng/mL,（283.52±102.92）μg/L],and the differences were statistically significant（tIFABP=27.51,tD-Lactate=4.33,P〈0.05）;the serum IFABP and D-Lactate of patients with simple intestinal obstruction and patients with strangulated intestinal obstruction in the observation group in 6h after admission decreased compared with those in 1 h after admission[（212.06±68.83）ng/mL,（234.61±64.05）μg/L vs（210.98±70.21）ng/mL,（235.86±64.57）μg/L],and the differences were statistically significant（tsingle IFABP=28.67,tsingle D-Lactate=2.21,tstrangulated IFABP=45.85,t_（strangulated D Lactate）=6.73,P〈0.05）,and the difference between the two kinds of diseases in the observation g

关 键 词：肠脂肪酸结合蛋白 D-乳酸 急性肠梗阻 诊断 预后 

分 类 号：R574[医药卫生—消化系统]