血清I-FABP和CBG对新生儿坏死性小肠结肠炎需要选择手术治疗的预测价值  

The value of serum I-FABP and CBG in predicting the need for surgical treatment of neonatal necrotizing enterocolitis

作　　者：杨福江 胡博[1] 戴春娟[1] 马林 赵绪稳[1] 王金虎[1] 杜晓斌[1] YANG Fujiang;HU Bo;DAI Chunjuan;MA Lin;ZHAO Xuwen;WANG Jinhu;DUXiaobin(Department of Neonatal Surgery,Tianjin Children's Hosptial,Tianjin 300074,CHINA)

机构地区：[1]天津市儿童医院(天津大学儿童医院)新生儿外科,天津300074

出　　处：《江苏医药》2024年第6期577-581,共5页Jiangsu Medical Journal

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK040A);天津市儿童医院发展基金计划项目(Y2020006)。

摘　　要：目的探讨血清肠型脂肪酸结合蛋白(I-FABP)和β葡萄糖苷酶(CBG)对新生儿坏死性小肠结肠炎(NEC)需要选择手术治疗的预测价值。方法93例确诊为NEC的新生儿,根据患儿住院后是否进行手术治疗分为手术组(27例)和非手术组(66例)。比较两组患儿一般资料及确诊NEC时血清I-FABP、CBG水平。采用多因素logistic回归分析NEC患儿选择手术治疗的独立影响因素。分析血清I-FABP和CBG单独及联合检测对NEC患儿行手术治疗的预测价值。结果手术组血清I-FABP及CBG水平高于非手术组(P<0.05)。多因素logistic回归分析结果显示,确诊NEC时血清I-FABP及CBG水平升高是NEC患儿行手术治疗的独立危险因素(P<0.05)。血清I-FABP联合CBG检测预测NEC患儿行手术治疗的AUC为0.941[95%CI(0.888~0.993),P<0.01],相应的预测灵敏度和特异度分别为85.0%和94.0%。结论确诊NEC时的血清I-FABP和CBG水平有助于早期预测需行手术治疗的NEC患儿。Objective To explore the predictive value of serum intestinal fatty acid binding protein(I-FABP)andβ-glucosidase(CBG)in the need for surgical treatment of neonatal necrotizing enterocolitis(NEC).Methods A total of 93 newborns diagnosed with NEC were divided into two groups of A(underwent surgical treatment,27 cases)and B(underwent non-surgical treatment,66 cases).The general information and serum I-FABP and CBG levels at the time of NEC diagnosis were compared between the two groups.Multivariate logistic regression analysis was used to investigate the independent influencing factors in the need of surgical treatment in NEC patients.Results Serum levels of I-FABP and CBG in group A were higher than those in group B(P<0.05).The results of multivariate logistic regression analysis showed that the elevated levels of I-FABP and CBG at the time of NEC diagnosis were the independent risk factors for the need of surgical treatment in NEC patients(P<0.05).The AUC of I-FABP combined with CBG detection in predicting NEC patients requiring surgical treatment was 0.941[95%CI(0.888-0.993),P<0.01],with corresponding predictive sensitivity and specificity of 85.0%and 94.0%,respectively.Conclusion Serum levels of I-FABP and CBG at the time of neonatal NEC diagnosis can help to predict the need for surgical treatment in the early stage.

关 键 词：新生儿 坏死性小肠结肠炎 肠型脂肪酸结合蛋白 β葡萄糖苷酶 

分 类 号：R722[医药卫生—儿科]