血清瓜氨酸、肠型脂肪酸结合蛋白、肠三叶因子对急性冠脉综合征并发应激性溃疡的诊断价值  

Diagnostic values of serum citrulline, intestinal fatty acid-binding protein,and intestinal trefoil factoRfoRacute coronary syndrome complicated with stress ulcer

作　　者：卢俊霖 廖伟 李俭成 冯代莉 廖雪梅 LU Jun-lin;LIAO Wei;LI Jian-cheng;FENG Dai-li;LIAO Xue-mei(Department of Emergency,Chongqing Rongchang District People′s Hospital,Chongqing 402460,China;Department of Cardiology,Chongqing Rongchang District People′s Hospital,Chongqing 402460,China)

机构地区：[1]重庆市荣昌区人民医院急诊科,重庆市402460 [2]重庆市荣昌区人民医院心内科,重庆市402460

出　　处：《广西医学》2021年第13期1570-1574,共5页Guangxi Medical Journal

基　　金：重庆市卫生健康委员会科研项目(2018MSXM181)。

摘　　要：目的探讨血清瓜氨酸、肠型脂肪酸结合蛋白(IFABP)、肠三叶因子(ITF)对急性冠脉综合征(ACS)并发应激性溃疡的诊断价值。方法以120例ACS患者作为研究对象,将其中75例单纯ACS患者作为ACS组,45例ACS并发应激性溃疡患者作为ACS并发应激性溃疡组,另选取60例健康人群作为对照组。采用高效液相色谱法检测各组血清瓜氨酸水平,采用酶联免疫吸附法检测各组血清IFABP、ITF水平。采用受试者工作特征(ROC)曲线评估血清瓜氨酸、IFABP、ITF及三者联合检测对ACS并发应激性溃疡的诊断价值,采用Logistic回归模型分析ACS并发应激性溃疡的相关影响因素。结果对照组、ACS组、ACS并发应激性溃疡组血清瓜氨酸水平依次降低,血清IFABP水平和ITF水平依次升高(均P<0.05);血清瓜氨酸水平、IFABP水平、ITF水平及三者联合检测诊断ACS并发应激性溃疡的ROC曲线下面积分别为0.689、0.804、0.863、0.932;血清ITF诊断ACS并发应激性溃疡的曲线下面积高于血清瓜氨酸、IFABP,三者联合检测诊断ACS并发应激性溃疡的曲线下面积高于血清瓜氨酸、IFABP和ITF单独诊断(均P<0.05);Logistic回归分析结果显示,血清瓜氨酸水平升高是影响ACS患者并发应激性溃疡的保护因素,血清IFABP和ITF水平升高是影响ACS患者并发应激性溃疡的独立危险因素(均P<0.05)。结论ACS并发应激性溃疡患者血清瓜氨酸水平明显降低,IFABP和ITF水平明显升高,三者可能参与ACS并发应激性溃疡的发生发展,对ACS并发应激性溃疡具有一定的诊断价值,且联合检测的诊断价值较高。Objective To investigate the diagnostic values of serum citrulline,intestinal fatty acid-binding protein(IFABP),and intestinal trefoil factor(ITF)foRacute coronary syndrome(ACS)complicated with stress ulcer.Methods A total of 120 patients with ACS were selected as research subjects.Among them,75 patients with ACS alone were enrolled as ACS group,45 patients with ACS complicated with stress ulceRas ACS complicated with stress ulceRgroup,and anotheR60 healthy individuals as control group.Serum citrulline level was detected in each group by high-performance liquid chromatography,and serum IFABP and ITF levels were detected in each group by enzyme-linked immunosobent assay.The diagnostic values of serum citrulline,IFABP,ITF,and theiRcombination foRACS complicated with stress ulceRwere evaluated by receiveRoperating characteristic(ROC)curve,the Logistic regression model was used to analyze the related influencing factors of ACS complicated with stress ulcer.Results Serum citrulline level decreased and serum IFABP and ITF levels increased in the sequence of the control group,the ACS group and the ACS complicated with stress ulceRgroup(all P<0.05);foRdiagnosing ACS complicated with stress ulcer,serum citrulline level,IFABP level,ITF level,and theiRcombination presented the areas undeRROC curve of 0.689,0.804,0.863 and 0.932,respectively;foRdiagnosing ACS complicated with stress ulcer,serum ITF yielded a higheRarea undeRthe curve than serum citrulline oRIFABP,while the combined detection of the three indicators exhibited a higheRarea undeRthe curve than serum citrulline,IFABP oRITF alone(all P<0.05);and the results of Logistic regression analysis showed that elevated serum citrulline level was the protective factoRinfluencing the incidence of concomitant stress ulceRin ACS patients,and elevated serum IFABP and ITF levels were the independent risk factors influencing the incidence of concomitant stress ulceRin ACS patients(all P<0.05).Conclusion Notably decreased serum citrulline level and significantly increased IFABP an

关 键 词：急性冠脉综合征 应激性溃疡 血清瓜氨酸 血清肠型脂肪酸结合蛋白 血清肠三叶因子 并发症 诊断 影响因素 

分 类 号：R541.4[医药卫生—心血管疾病]