肠型脂肪酸结合蛋白和粪钙卫蛋白联合检测在足月新生儿坏死性小肠结肠炎中的应用价值

Value of combined measurement of intestinal fatty acid-binding protein and fecal calprotectin in diagnosis of necrotizing enterocolitis in full-term neonates

摘要:

目的 探讨肠型脂肪酸结合蛋白 （I-FABP）、粪钙卫蛋白 （FC）联合检测在足月新生儿坏死性小肠结肠炎 （NEC）诊断中的应用价值。方法 选择足月新生儿NEC36例 （病例组）和同期非消化系统疾病新生儿39例 （对照组）为研究对象。采用酶联免疫吸附法 （ELISA）分别检测两组患儿血清I-FABP及粪便中FC的水平，并评估I-FABP联合FC诊断NEC的临床价值。结果 病例组I-FABP和FC显著高于对照组 （P < 0.05）；病例组患儿血清I-FABP与粪便中FC呈现正相关 （r=0.71，P < 0.05）；分别以I-FABP、FC及两指标联合为参考，诊断NEC的敏感性分别为83.3%，81.5%和79.5%；特异性分别为72.5%，75.8和86.3%，诊断的ROC曲线下面积 （AUC）分别为0.82，0.81和0.88。联合检测诊断NEC的特异性和AUC明显高于单一检测 （P < 0.05）。结论 I-FABP与FC在NCE患儿显著升高，且两者存在相关性，联合检查可提高诊断NEC的特异性。

Abstract:

Objective To study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates. Methods A total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated. Results The case group had significantly higher I-FABP and FC levels than the control group (P < 0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P < 0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P < 0.05). Conclusions Children with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.