血清sICAM-1、I-FABP水平对新生儿窒息并发急性肠损伤的诊断价值  

Diagnostic value of serum sICAM-1 and I-FABP levels in neonatal asphyxia complicated with acute intestinal injury

作　　者：王丽 王秋月[1] 花少栋 WANG Li;WANG Qiuyue;HUA Shaodong(General Hospital of Aeronautics,Beijing 100012,China)

机构地区：[1]航空总医院,北京100012 [2]八一儿童医院

出　　处：《山东医药》2019年第31期5-8,共4页Shandong Medical Journal

基　　金：北京市科技计划项目(Z161100000516019)

摘　　要：目的探讨血清可溶性细胞间黏附分子1(sICAM-1)、肠型脂肪酸结合蛋白(I-FABP)对新生儿窒息并发急性肠损伤的诊断价值。方法选择窒息新生儿153例,根据是否并发急性肠损伤分为合并肠损伤组65例(其中轻度39例、重度26例)、单纯窒息组88例。同期选择健康新生儿50例作为对照组。采集各组空腹肘静脉血,采用ELISA法检测血清sICAM-1、I-FABP。采用受试者工作特征(ROC)曲线评估血清sICAM-1、I-FABP水平对新生儿窒息并发急性肠损伤的诊断价值。结果合并肠损伤组、单纯窒息组血清sICAM-1、I-FABP水平均高于对照组,且合并肠损伤组血清sICAM-1、I-FABP水平均高于单纯窒息组(P均<0.05)。重度肠损伤窒息新生儿血清sICAM-1、I-FABP水平均高于轻度肠损伤窒息新生儿(P均<0.05)。血清sICAM-1、I-FABP单独检测诊断窒息新生儿并发急性肠损伤的曲线下面积(AUC)分别为0.841、0.868(95%CI分别为0.774~0.914、0.800~0.936),其最佳截断值分别为18.97、109.85μg/mL,此时其诊断窒息新生儿并发急性肠损伤的敏感性分别为79%、86%,特异性分别为83%、91%,准确性分别为80%、85%。血清sICAM-1、I-FABP联合检测诊断窒息新生儿并发急性肠损伤的AUC为0.945(95%CI:0.909~0.981),其诊断敏感性为92%、特异性为97%、准确性为94%。血清sICAM-1、I-FABP联合检测诊断窒息新生儿并发急性肠损伤的AUC高于二者单独检测(Z分别为3.562、4.112,P均<0.05)。结论窒息新生儿并发急性肠损伤者血清sICAM-1、I-FABP水平明显升高,并与急性肠损伤程度密切相关。早期联合检测血清sICAM-1、I-FABP可辅助诊断窒息新生儿并发急性肠损伤。Objective To explore the diagnostic value of serum soluble intercellular adhesion molecule 1(sICAM-1)and intestinal fatty acid binding protein(I-FABP)in neonatal asphyxia complicated with acute intestinal injury.Methods Totally 153 neonates with asphyxia were selected and divided into the combined intestinal injury group(65 cases)and simple asphyxia group(88 cases)according to whether they were complicated with acute intestinal injury or not.There were 39 cases of mild intestinal injury and 26 cases of severe intestinal injury in the combined intestinal injury group.At the same time,50 healthy newborns were selected as the control group.Fasting elbow venous blood was collected and serum was collected by centrifugation.Serum sICAM-1 and I-FABP were detected by ELISA.The diagnostic value of serum sICAM-1 and I-FABP levels in neonatal asphyxia complicated with acute intestinal injury was evaluated by ROC curve.Results The levels of serum sICAM-1 and I-FABP in the combined intestinal injury group and the simple asphyxia group were higher than those in the control group,and the levels of serum sICAM-1 and I-FABP in the combined intestinal injury group were higher than those in the simple asphyxia group(all P<0.05).The serum levels of sICAM-1 and I-FABP in neonates with severe intestinal injury and asphyxia were higher than those in neonates with mild intestinal injury and asphyxia(both P<0.05).The AUC of serum sICAM-1 and I-FABP were 0.841 and 0.868,respectively(95%CI=0.774-0.914,0.800-0.936),the best cut-off values were 18.97 and 109.85μg/mL,respectively;at this time,the sensitivities in diagnosis of asphyxiated neonates with acute intestinal injury were 79%and 86%and the specificities were 83%and 91%,and the accuracies were 80%and 85%,respectively.The AUC of combined detection of serum sICAM-1 and I-FABP for the diagnosis of acute intestinal injury in asphyxiated neonates was 0.945(95%CI:0.909-0.981).The sensitivity,specificity,and accuracy for the diagnosis of acute intestinal injury in asphyxiated neonates were 9

关 键 词：新生儿窒息 急性肠损伤 可溶性细胞间黏附分子1 肠型脂肪酸结合蛋白 

分 类 号：R725.6[医药卫生—儿科]