肠型脂肪酸结合蛋白在成人危重症胃肠功能衰竭早期诊断中的价值(1)
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[摘要] 目的：分析肠型脂肪酸结合蛋白(intestinal fatty acid binding protein，I-FABP)与危重症胃肠功能衰竭的关系。方法：将我院消化内科重症监护室病房2009年3月～2010年3月住院的37例胃肠道疾病患者分为衰竭组(21例)和非衰竭组(16例)，另选与前两组相匹配的同期在我院门诊行健康体检的正常成人37例作为对照组，用酶联免疫吸附法(ELISA)分别检测三组患者血清I-FABP浓度。结果：三组患者血清I-FABP浓度分别为(11.19±1.92)、(6.13±2.14)、(3.48±2.31)μg/L，三组血清浓度的比较，差异具有高度统计学意义(P<0.01)。结论：血清I-FABP在成人危重症胃肠功能衰竭早期即出现增高，可作为成人危重症胃肠功能衰竭早期诊断的一个敏感指标。
[关键词] 肠型脂肪酸结合蛋白；胃肠功能衰竭；酶联免疫吸附法
[中图分类号] R725.7[文献标识码]B[文章编号]1673-7210(2011)08(a)-158-02
The early diagnosis value of intestinal fatty acid binding protein in gastrointestinal failure adults
LIU Gang, JIANG Chuanshen, LI Haitao
Department of Digestive System, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China
[Absract] Objective: To analyze the relationship between the I-FABP level and critical gastrointestinal failure. Methods: 37 patients in the digestive system ICU department were divided into the gastrointestinal failure group (n=21), non-gastrointestinal failure group (n=16) from March 2009 to March 2010, with 37 health adults in the same time as the control group. Then the I-FABP levels were measured in three groups by ELISA. Results: The I-FABP in three groups were (11.19±1.92), (6.13±2.14), (3.48±2.31) μg/L, respectively. There were significant differences between three groups in the I-FABP level (P<0.01). Conclusion: The I-FABP levels in patients with gastrointestinal failure have increased in early period, it can be used as a sensitive index in the early gastrointestinal failure.
[Key words] Intestinal fatty acid binding protein; Gastrointestinal failure; ELISA
胃肠功能衰竭是指机体在受到创伤、感染、失血等严重损害时，胃肠道出现的严重的应激反应，表现为：①糖皮质激素分泌增加，使蛋白分解加速，胃肠道黏膜变薄；②释放大量儿茶酚胺，使胃肠黏膜血管收缩，致胃肠黏膜缺血、缺氧、坏死，临床表现为急性胃黏膜病变、应激性溃疡、出血、穿孔等；③胃肠激素分泌紊乱，如胃动素、胃泌素、神经肽、血管活性肠肽等，使胃肠功能紊乱，出现腹胀、呕吐，胃肠蠕动变缓甚至停止等临床表现[1]。研究表明，肠型脂肪酸结合蛋白(intestinal fatty acid binding protein，I-FABP)在正常人的血清中虽不能被检测出，但当有肠黏膜损伤时，I-FABP释放入血，导致血浆I-FABP浓度上升。Sonnino等[2]用ELISA法证实，血清I-FABP是一种对于肠黏膜损伤敏感且特异的生化指标，并可用于同种同基因肠移植的移植物或全身炎症反应综合征(systemic inflammatory resporse syndrome，SIRS)的监测。本研究试图通过病例对照的研究方法来探讨I-FABP与危重症胃肠功能衰竭的关系。
1 资料与方法
1.1 一般资料
选择2009年3月～2010年3月在我科重症监护病房住院治疗的危重症患者37例，男19例，女18例，胃肠功能衰竭主要表现为腹胀、肠鸣音减弱或消失 ......
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