I-FABP、CRP联合肠系膜上动脉超声检测对新生儿坏死性小肠结肠炎的诊断价值  

Diagnostic Value of I-FABP and CRP Combined with Superior Mesenteric Artery Ultrasonography in Necrotizing Enterocolitis of Newborn

作　　者：闫海娜 王云花 YAN Hai-na;WANG Yun-hua(Department of Neonatology,Anyang Maternal and Child Health Hospital,Anyang 455000,Henan Province,China;Department of Pediatrics,Hebi People's Hospital,Hebi 458030,Henan Province,China)

机构地区：[1]安阳市妇幼保健院新生儿科,河南安阳455000 [2]鹤壁市人民医院儿科,河南鹤壁458030

出　　处：《罕少疾病杂志》2025年第1期121-123,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨肠型脂肪酸结合蛋白(I-FABP)、C反应蛋白(CRP)联合肠系膜上动脉(SMA)超声检测对新生儿坏死性小肠结肠炎(NEC)的诊断价值。方法 选择2020年5月至2022年5月80例疑似NEC(Bell分期I期)患儿,以及同期72例确诊NEC(Bell分期II期)和40例无胃肠疾病的新生儿(对照组),行彩色多普勒超声检测SMA收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI),同时检测血清I-FABP、CRP水平。结果 三组首检SMA超声PSV、EDV、RI比较差异显著(P<0.05),与对照组比较,疑似组PSV明显降低(P<0.05),RI明显增高(P<0.05),而EDV比较无明显差异(P>0.05);与确诊组比较,疑似组RI明显减小(P<0.05),而PSV、EDV比较无明显差异(P>0.05)。三组血清I-FABP、CRP水平具有统计学意义(P<0.05),与对照组比较,疑似组血清I-FABP、CRP水平明显提高(P<0.05);与确诊组比较,疑似组I-FABP水平明显降低(P<0.05),而CRP比较无明显差异(P>0.05)。ROC曲线分析显示,SMA超声+I-FABP+CRP联合诊断早期NEC的敏感性、特异性分别为87.1%、85.9%,AUC为0.834(95%CI:0.712~0.926),均高于单一诊断。结论 I-FABP、CRP及SMA超声检查对NEC具有诊断价值,三者联合对NEC具有较高的敏感性和特异性。Objective To investigate the diagnostic value of enteric fatty acid-binding protein(I-FABP)and C-reactive protein(CRP)combined with superior mesenteric artery(SMA)ultrasonography in neonates with necrotizing enterocolitis(NEC).Methods From May 2020 to May 2022,80 patients with suspected NEC(Bell stage I),72 patients with confirmed NEC(Bell stage II)and 40 neonates without gastrointestinal disease were selected(control group).The peak systolic flow rate(PSV),end-diastolic flow rate(EDV)and resistance index(RI)of SMA were detected by color Doppler ultrasound,and the serum I-FABP and CRP levels were also detected.Results There were significant differences in PSV,EDV and RI among the three groups at the first SMA examination(P<0.05).Compared with the control group,PSV in the suspected group was significantly decreased(P<0.05),RI was significantly increased(P<0.05),but EDV was not significantly different(P>0.05).Compared with confirmed group,RI in suspected group was significantly decreased(P<0.05),while PSV and EDV were not significantly different(P>0.05).The levels of serum I-FABP and CRP in the three groups were statistically significant(P<0.05).Compared with the control group,the levels of serum I-FABP and CRP in the suspected group were significantly increased(P<0.05).Compared with the confirmed group,the level of I-FABP in the suspected group was significantly decreased(P<0.05),but there was no significant difference in CRP(P>0.05).ROC curve analysis showed that the sensitivity and specificity of SMA ultrasound+I-FABP+CRP in the diagnosis of early NEC were 87.1%and 85.9%,respectively,and the AUC was 0.834(95%CI:0.712-0.926),which were higher than that of single diagnosis.Conclusion Ultrasound examination of I-FABP,CRP and SMA is valuable in the diagnosis of NEC,and the combination of the three has high sensitivity and specificity for NEC.

关 键 词：新生儿坏死性小肠结肠炎 肠型脂肪酸结合蛋白 C反应蛋白 肠系膜上动脉 彩色多普勒超声 

分 类 号：R574.62[医药卫生—消化系统]