尿肠型脂肪酸结合蛋白和粪钙卫蛋白在新生儿坏死性小肠结肠炎中的诊断价值  

Diagnostic Value of Urine Intestinal Fatty Acid Binding Protein( IFABP) and Fecal Calpmtectin( FC) in Neonatal Necrotizing Enterocolitis

作　　者：李海静[1] 朱敏丽[1] 黄玉梅[1] 姜娜[1] 林振浪[1] Li Haijing;Zhu Minli;Huang Yumei(Department of Neonatology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院新生儿科

出　　处：《医学研究杂志》2019年第11期118-121,共4页Journal of Medical Research

基　　金：浙江省温州市科技局项目(Y20110056)

摘　　要：目的探讨尿肠型脂肪酸结合蛋白(IFABP)和粪钙卫蛋白(FC)在新生儿坏死性小肠结肠炎(NEC)中的变化以及与喂养不耐受患儿的鉴别诊断价值.方法以2015年1月~2016年12月收住笔者科室的胎龄(GA)≤34周且出生体重(BW)≤2500g的适于胎龄早产儿90例为观察对象,共分为3组,即期间发生NEC的患儿作为NEC组,在同期入院的患儿中按照喂养耐受情况,分别作为喂养不耐受组和喂养耐受组(对照组).所有入组患儿均在临床诊断的第1天、第5天分别收集尿液、粪便标本各1份,采用定量酶联免疫吸附方法(ELISA)检测尿液IFABP和FC浓度.结果每组共纳入30例早产儿,NEC组平均胎龄29.8±2.1周,喂养不耐受组平均胎龄30.2±2.4周,对照组平均胎龄30.8±2.5周,3组患儿的胎龄差异无统计学意义(P>0.05).IFABP浓度NEC组在第1天即明显升高,平均为8.821±1.551 ng/ml,第5天时达到11.103±1.718ng/ml,显著高于喂养不耐受组(3.150±1.484ng/ml vs 3.148±1.489ng/ml,P均<0.01)和对照组(3.005±1.430ng/ml vs 3.047±1.216ng/ml,P均<0.01);但第1天和第5天喂养不耐受组与对照组IFABP浓度比较,差异均无统计学意义(P=0.708,0.794).FC浓度NEC组在第1天即明显升高,平均为303.34±59.72μg/g,第5天时达到458.05±121.08μg/g,显著高于喂养不耐受组(176.53±51.31μg/g vs181.29+41.15μg/g,P均<0.01)和对照组(183.54±40.67μg/g vs 181.90+38.80μg/g,P均<0.01);但第1天和第5天喂养不耐受组与对照组FC浓度比较,差异均无统计学意义(P=0.597,0.796).结论尿液IFABP和FC在NEC发生时即有升高,而喂养不耐受患儿无明显升高,尿IFABP联合FC检测可能成为NEC早期诊断和鉴别喂养不耐受患儿的一个敏感而特异的指标.Objective To examine the dynamic changes of urine intestinal fatty acid binding protein(IFABP)and fecal calpmtectin(FC)in neonatal necrotizing enterocolitis(NEC)and to explore their roles in differential diagnosis of neonatal necrotizing enterocolitis(NEC)and feeding Intolerance in preterm infants.Methods Anonymized data for preterm infants of gestational age(GA)W34 weeks,birth weight(BW)w2500g between January 2015 and December 2016 were obtained from Neonatal Intensive Care Unit of our Hospital.To establish the NEC group,we randomly selected 30 cases of NEC.According to the feeding tolerance,we established feeding intolerance group and feeding tolerance(control group)in the same period,respectively.As long as infants were clinically diagnosed,their urine and stool were collected at the first day and the fifth day.IFABP and FC were measured by ELISA.Results Thirty preterm infants were included in each group.The average gestational age of NEC group was 29.8±2.1 weeks.The average gestational age of feeding intolerance group was 30.2±2.4 weeks,and the average gestational age of the control group was 30.8±2.5 weeks.There was no difference in GA in the three groups(P>0.05).The concentration of IFABP in NEC group increased significantly at the first day,the average concentration of IFABP was 8.821±1.551ng/ml.At the fifth day,the concentration of IFABP was up to 11.103±1.718ng/ml.The concentration of IFABP was obviously higher in NEC group than the feeding intolerance groups(3.150±1.484ng/ml vs 3.148±1.489ng/ml,P<0.01),and the control group(3.005±1.430ng/ml vs 3.047±1.216ng/ml,P<0.01).However,for the concentration of IFABP,we found no difference between the feeding intolerance group and the control group at the first day and the fifth day(P=0.708,0.794).Similar to IFABP,the concentration of FC in NEC group increased at the first day,and the average concentration of FC was 303.34±59.72μg/g.At the fifth day,the concentration of FC was up to 458.05±121.08μg/g.We found that the concentration of FC were signific

关 键 词：早产儿 肠型脂肪酸结合蛋白 粪钙卫蛋白 喂养不耐受 坏死性小肠结肠炎 

分 类 号：R72[医药卫生—儿科]