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 NECⅡ、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21.8μg/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1657.8μg/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。
Objective To investigate the value of serum intestinal fatty acid binding protein （I-FABP） and serum amy- loid 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 （stage I ：26 cases; stage Ⅱ/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 immunosor- bent assay.The diagnostic value of I-FABP and SAA for severe NEC was assessed using the receiver operating character- istic （ROC）curve. Results Stage Ⅱ/Ⅲ cases in the case group had significantly higher serum I-FABP levels and SAA levels than the control group and Stage I cases （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 opti- mal cut-off point of 1657.8 μg/L. Under this cut-off point, the sensitivity and specificity were 67.0% and 80.0%, respec- tively. Conclusion In newborn infants with NEC, serum I-FABP and SAA 1 can be used as biomarkers for the diagno- sis of severe NEC.
出处
《中国实用儿科杂志》
CSCD
北大核心
2017年第11期838-841,共4页
Chinese Journal of Practical Pediatrics
基金
广东省医学科学技术研究基金(A2014100)
