血清I-FABP、D-Dimer诊断急性肠缺血的实验研究  

Value of Plasma I-FABP and D-Dimer in the Early Diagnosis of Acute Intestinal Ischemia

作　　者：李海坤[1] 王敏华 周小青 殷青辉 叶斌 曾祥福[1] 刘晓平[1] 朱贤森[3] 胡艳 曾祥泰[1,2] LI Hai-kun;WANG Min-hua;ZHOU Xiao-qing;YIN Qing-hui;YE Bin;ZENG Xiang-fu;LIU Xiao-ping;ZHU Xian-sen;Hu Yan;Zeng Xiang-tai(Department of Gastro-intestinal Surgery,The First Hospital of Gan-Nan Medical University,Gan Zhou 341000,China;The First Department of Surgery,The Second Hospital of Gan-Nan Medical University,Gan Zhou 341000,China;Department of pathology,Gannan Medical University,Gan Zhou 341000,China;Gan Zhou Animal Husbandry Research Institute,GanZhou 341000,China)

机构地区：[1]赣南医学院第一附属医院胃肠外科,江西省赣州市341000 [2]赣南医学院第二附属医院外一科,江西省赣州市341000 [3]赣南医学院病理教研室,江西省赣州市341000 [4]赣州市畜牧科学研究所,江西省赣州市341000

出　　处：《中国全科医学》2017年第B12期28-30,共3页Chinese General Practice

基　　金：江西省教育厅科技项目(GJJ08402)

摘　　要：目的探讨联合检测血清血清肠脂肪酸结合蛋白(I-FABP)、D-二聚体(D-Dimer)浓度变化对肠缺血早期诊断的意义。方法选取健康成年SD大鼠96只,随机分为实验组和对照组,每组48只,两组内再随机分成6小组,每组8只。实验组结扎肠系膜上动脉,对照组仅行腹腔开关术。各小组大鼠分别对应在手术后0.5 h,1 h,2 h,4 h,8 h,12 h 6个时间点抽取静脉血检测I-FABP和D-二聚体浓度,对相应时间点大鼠切取病变肠管并观察肠管病理形态学改变。结果实验组在肠缺血0.5 h血清I-FABP开始升高,1 h达峰值(290.24±156.69)μg/L,之后逐渐下降,与对照组比较,差异具有统计学意义(P<0.05)。血浆D-Dimer浓度在缺血2 h内升高不明显,与对照组比较,差异无统计学意义(P>0.05);在肠缺血4 h之后开始升高,随缺血时间的延长而升高,与对照组相比,差异具有统计学意义(P<0.05)。结论联合检测血清I-FABP、D-Dimer浓度变化对肠缺血早期诊断及对肠管血液供应状态的判断具有一定的意义。Objective To explore the value of plasma I-FABP and D-Dimer in the early diagnosis of acute intestinal ischemia.Methods 96 healthy adult SD rats were randomly divided into experimental group and control group,48 cases in each group.Rats in two groups were then randomly divided into 6 groups,8 in each group.Experimental group received ligation of superior mesenteric artery.Control group was given abdominal switch operation.The venous blood samples were extracted from each group rats at 0.5 h,1 h,2 h,4 h,8 h,12 h after the operation.The concentration of I-FABP and D-dimer was tested.At the corresponding time points,the damaged small intestines from the rats were taken to observe the pathological changes.Results Serum I-FABP concentration in experimental group began to increase at 0.5 h and reached a peak at 1h(290.24±156.69)μg/L,then gradually decreased.Compared with control group,the difference was statistically significant(P<0.05).Concentration of plasma D-Dimer in intestinal ischemia did not increase obviously within 2 hours.Compared with control group,the difference was not statistically significant(P>0.05).After 2 hours it increased gradually along with the extension of intestinal ischemia time,with significant difference(P<0.05).Conclusion Combined detection of serum I-FABP,D-Dimer concentration changes in intestinal ischemia has a certain significance for early diagnosis and judgment about the gut blood supply.

关 键 词：肠缺血 早期诊断 肠型脂肪酸结合蛋白 D-二聚体 

分 类 号：R574[医药卫生—消化系统]