联合肠型脂肪酸结合蛋白、D-乳酸及D-二聚体在急性肠系膜上动脉闭塞患者中的临床意义  

The diagnostic significance of combination detection of intestinal fatty acid binding protein,D-lactate and D-dimer in patients with superior mesenteric artery occlusion

作　　者：王天鹏 蒋成行[1] 胡升安 胡朝洲 WANG Tian-peng;JIANG Cheng-hang;HU Sheng-an;HU Chao-zhou(Department of Emergency Medicine,Zhejiang Province People's Hospital,People's Hospital Affiliated to Hangzhou Medical College,Hangzhou 310014,Zhejiang,China)

机构地区：[1]浙江省人民医院、杭州医学院附属人民医院急诊医学科,浙江杭州310014

出　　处：《广东医学》2020年第21期2205-2208,共4页Guangdong Medical Journal

摘　　要：目的探讨联合肠型脂肪酸结合蛋白(intestinal fatty acid binding protein,I-FABP)、D-乳酸及D-二聚体在急性肠系膜上动脉闭塞患者早期诊断的临床意义.方法选择急性腹痛患者93例,其中32例为通过腹部血管B超、CTA或DSA确诊的急性肠系膜上动脉闭塞患者作为观察组,其余61例患者为对照组.检验93例患者入院就诊后I-FABP、D-乳酸及D-二聚体水平.对照两组间I-FABP、D-乳酸及D-二聚体水平.结果观察组I-FABP、D-乳酸及D-二聚体水平均高于对照组(P<0.05).I-FABP、D-乳酸、D-二聚体水平及三者联合在诊断急性肠系膜上动脉闭塞患者形成的受试者工作特征(ROC)曲线下面积分别是0.810(95%CI 0.719~0.902,P<0.001)、0.806(95%CI 0.707~0.904,P<0.001)、0.695(95%CI 0.584~0.806,P=0.002)、0.918(95%CI 0.850~0.985,P<0.001).结论I-FABP、D-乳酸及D-二聚体对早期诊断急性肠系膜上动脉闭塞患者有临床意义.三者联合检测可显著提高早期诊断急性肠系膜上动脉闭塞的特异性及敏感性.Objective To investigate the early diagnostic significance of combination detection of intestinal fatty acid binding protein(I-FABP), D-lactate and D-dimer in patients with superior mesenteric artery occlusion. Methods Ninety-three patients with acute abdominal pain were selected. Thirty-two patients with superior mesenteric artery occlusion confirmed by B-ultrasound, CTA or DSA were selected as the observation group, and the remaining 61 patients were selected as the control group. The levels of I-FABP, D-lactate and D-dimer were measured in all 93 patients. The levels of I-FABP, D-lactate and D-dimer were compared. Results The levels of I-FABP, D-lactate and D-dimer in the observation group were significantly higher than those in the control group(P<0.05). The areas under the ROCs of I-FABP, D-lactate, D-dimer and their combination detection in the diagnosis of superior mesenteric artery occlusion were 0.810(95%CI: 0.719-0.902, P<0.001), 0.806(95%CI: 0.707-0.904, P<0.001), 0.695(95%CI: 0.584-0.806, P=0.002), and 0.918(95%CI: 0.850-0.985, P<0.001), respectively. Conclusion I-FABP, D-lactate and D-dimer have clinical significance in the early diagnosis of superior mesenteric artery occlusion. The combined detection of the three indexes can significantly improve the specificity and sensitivity of early diagnosis of superior mesenteric artery occlusion.

关 键 词：急性肠系膜上动脉闭塞 肠型脂肪酸结合蛋白 D-乳酸 D-二聚体 

分 类 号：R446.112[医药卫生—诊断学] R572.3[医药卫生—临床医学]