中国实用儿科杂志

中国实用儿科杂志

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血清肠型脂肪酸结合蛋白联合血清淀粉样蛋白Ａ诊断重症新生儿坏死性小肠结肠炎应用价值研究

  

  1. 广东省妇幼保健院 a 新生儿科； b 保健部， 广东  广州  511442
  • 出版日期:2017-11-06 发布日期:2017-11-09

Value of serum intestinal fatty acid binding protein and serum amyloid A in the diagnosis of severe necrotizing enterocolitis in the newborn

  1. *Department of Neonatology，Guangdong Women and Children’s Hospital，Guangzhou  511442，China
  • Online:2017-11-06 Published:2017-11-09

摘要：

目的    探讨血清肠型脂肪酸结合蛋白（I-FABP）和血清淀粉样蛋白A（SAA）在诊断重症新生儿坏死性小肠结肠炎（NEC）的应用价值。方法　2014年10月至2015年10月在广东省妇幼保健院确诊为NEC的56例早产儿为病例组，其中Ⅰ期患儿26例，Ⅱ、Ⅲ期患儿30例；同期确诊为非消化系统疾病的30例患儿为对照组。采用酶联免疫吸附法（ELISA）检测各组患儿血清I-FABP和SAA水平。采用受试者工作特征曲线（ROC）对I-FABP和SAA诊断重症NEC进行评估。结果　NEC Ⅱ、Ⅲ期组血清I-FABP水平和SAA水平均显著高于NECⅠ期组和对照组（P＜0.05）；I-FABP血清标志物ROC曲线下面积（AUC）为0.80（95%CI：0.69～0.92），最佳截点值为21.8 μg/L，该截点值下诊断重症NEC的敏感度为70.0%，特异度为81.0%。SAA血清标志物ROC曲线下面积（AUC）为0.76（95%CI：0.63～0.89），最佳截点值为1657.8 μg/L，该截点值下诊断重症NEC的敏感度为67.0%，特异度为85.0%。结论　血清I-FABP和SAA可作为诊断NEC病情严重程度的参考指标。

关键词: 血清肠型脂肪酸结合蛋白, 血清淀粉样蛋白A, 新生儿, 坏死性小肠结肠炎

Abstract:

Objective　To investigate the value of serum intestinal fatty acid binding protein（I-FABP） and serum amyloid A（SAA） in the diagnosis of necrotizing enterocolitis（NEC）in the newborn. Methods　Fifty-six preterm infants with a confirmed diagnosis of NEC from October 2014 to October 2015 were recruited as case group（stageⅠ：26 cases；stageⅡ/Ⅲ：30 cases）. Thirty children diagnosed with non-digestive diseases in the same period were recruited as the control group. Serum levels of I-FABP and SAA were determined by enzyme-linked immunosorbent assay.The diagnostic value of I-FABP and SAA for severe NEC was assessed using the receiver operating characteristic（ROC）curve. Results　StageⅡ/Ⅲ cases in the case group had significantly higher serum I-FABP levels and SAA levels than the control group and StageⅠcases（P＜0.05）. The area under the ROC curve for serum I-FABP was 0.80（95%CI：0.69-0.92），with the optimal cut-off point of 21.8 μg/L. Under this cut-off point，the sensitivity and specificity were 70.0%and 81.0%，respectively. The area under the ROC curve for SAA was 0.76（95%CI：0.63-0.89），with the optimal cut-off point of 1657.8 μg/L. Under this cut-off point，the sensitivity and specificity were 67.0% and 80.0%，respectively. Conclusion　In newborn infants with NEC，serum I-FABP and SAA l can be used as biomarkers for the diagnosis of severe NEC.

Key words: intestinal fatty acidbinding protein, serum amyloid A, newborn infant, necrotizing enterocolitis