血清肠脂肪酸结合蛋白、碱性磷酸酶、D-二聚体在肠梗阻患者中的表达变化及临床价值研究  

Expression changes of serum intestinal fatty acid-binding protein,alkaline phosphatase and D-dimer in patients with intestinal obstruction and their clinical value

作　　者：丁宗豪 汪泳[1] 陈博[2] DING Zonghao;WANG Yong;CHEN Bo(Department of Gastrointestinal Surgery,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院胃肠外科,安徽合肥230601 [2]安徽医科大学第一附属医院普外科,安徽合肥230022

出　　处：《陕西医学杂志》2024年第3期340-343,共4页Shaanxi Medical Journal

基　　金：安徽省自然科学基金资助项目(2208085MH240)。

摘　　要：目的:探讨血清肠脂肪酸结合蛋白(IFABP)、碱性磷酸酶(ALP)、D-二聚体(D-D)在肠梗阻患者中表达变化及临床价值。方法:选取肠梗阻患者201例,根据是否行手术治疗分为手术组(105例)和保守治疗组(96例)。根据肠道血运情况将手术组分为单纯性肠梗阻组(46例)、无肠壁坏死组(34例)和肠壁坏死组(25例)。另选同期体检健康者40例为健康对照组。比较肠梗阻患者与健康对照组及不同肠道血运患者血清IFABP、ALP、D-D水平。分析绞窄性肠梗阻患者血清IFABP、ALP、D-D间的相关性。绘制受试者工作特征(ROC)曲线,分析血清IFABP、ALP、D-D水平对绞窄性肠梗阻的诊断价值。结果:手术组患者血清IFABP、ALP、D-D水平高于保守治疗组和健康对照组(均P<0.05)。保守治疗组血清IFABP水平高于健康对照组(P<0.05)。肠壁坏死组血清IFABP、ALP、D-D水平高于无肠壁坏死组及单纯性肠梗阻组,且无肠壁坏死组高于单纯性肠梗阻组(均P<0.05)。血清IFABP、ALP、D-D三者间均呈正相关(均P<0.05)。血清IFABP、ALP、D-D水平对绞窄性肠梗阻均有诊断价值,且三者联合检测的诊断价值更高。结论:肠梗阻患者血清IFABP、ALP、D-D水平升高,且与肠绞窄严重程度有关,三者联合检测对绞窄性肠梗阻均具有较高的诊断价值。Objective:To explore the expression changes of serum intestinal fatty acid-binding protein(IFABP),alkaline phosphatase(ALP)and D-dimer(D-D)in patients with intestinal obstruction and their clinical value.Methods:A total of 201 patients with intestinal obstruction were selected and divided into operation group(105 cases)and conservative treatment group(96 cases)according to whether or not surgery was performed.According to the intestinal blood flow,the operation group was divided into simple intestinal obstruction group(46 cases),no intestinal wall necrosis group(34 cases)and intestinal wall necrosis group(25 cases).Another 40 healthy subjects in the same period were selected as healthy control group.Serum levels of IFABP,ALP and D-D were compared between patients with intestinal obstruction and healthy control group and patients with different intestinal blood flow.The correlation of serum IFABP,ALP and D-D in patients with strangulated intestinal obstruction was analyzed.ROC curve was drawn to analyze the diagnostic value of serum IFABP,ALP and D-D levels in strangulated intestinal obstruction.Results:Serum levels of IFABP,ALP and D-D in operation group were higher than those in conservative treatment group and healthy control group(all P<0.05).The serum IFABP level in conservative treatment group was higher than that in healthy control group(P<0.05).Serum levels of IFABP,ALP and D-D in intestinal wall necrosis group were higher than those in non-intestinal wall necrosis group and simple intestinal obstruction group,and those in non-intestinal wall necrosis group were higher than those in simple intestinal obstruction group(all P<0.05).Serum IFABP,ALP and D-D were positively correlated(all P<0.05).Serum IFABP,ALP and D-D levels had diagnostic value for strangulated intestinal obstruction,and the combined detection of the three levels had a higher diagnostic value.Conclusion:The serum levels of IFABP,ALP and D-D in patients with intestinal obstruction are increased,and they are related to the severity of strangul

关 键 词：绞窄性肠梗阻 单纯性肠梗阻 肠脂肪酸结合蛋白 碱性磷酸酶 D-二聚体 诊断价值 

分 类 号：R574.2[医药卫生—消化系统]