5-HT、iFABP在重症急性胰腺炎肠功能障碍患者中的水平及临床价值

Level and clinical significance of 5-HT and iFABP in severe acute pancreatitis patients with intestinal dysfunction

目的 检测苇症急性胰腺炎（SAP）伴肠功能障碍患者血5-羟色胺（5-HT）及尿液中肠脂肪酸结合蛋白（iFABP）水平,探讨其临床应用价值.方法 ELASA法检测42例SAP伴肠功能障碍患者入院第1天、第3天及第7天血5-HT及尿iFABP的水平,同时记录肠鸣音次数;以20例健康体检人员作为对照组.结果 健康对照组平均肠鸣音次数为（5.6±2.3）次/min.SAP组入院第1天、第3天及第7天肠鸣音次数分别为（2.3±0.7）次/min、（1.7±0.2）次/min与（3.1±1.1）次/min,均较健康对照组显著减少（P值均〈0.01）.对照组血5-HT含量为（86.7±9.5）ng/ml,SAP组第1天、第3天、第7天含量分别为（112.0±17.8）ng/ml、（130.5±19.7）ng/ml、（107.9±16.3）ng/ml;对照组尿iFABP含量为（90.5±19.8）pg/ml,SAP组分别为（1250.2±425.3）pg/ml、（1586.9±523.4）pg/ml、（1154.6±394.0）pg/ml.SAP组的血5-HT和尿iFABP含量均较对照组显著增加（P值均〈0.01）;SAP组第3天的含量又较第1天及第7天显著增高,而第1天与第7天之间无显著差异.结论 在SAP早期检测血5-HT及尿iFABP可有效评估患者的肠功能状况,有潜在的临床应用价值.

Objective To determine the level and clinical significance of 5-hydroxytryptamine （5-HT） and intestinal fatty acid binding protein （iFABP） in patients of severe acute pancreatitis （SAP） with intestinal dysfunction. Methods The serum and urine in 42 cases of SAP with intestinal dysfunction were collected at day 1, 3 and 7 after admission, respectively. The numbers of bowel sounds were recorded. 20 health subjects were selected as the control. Results The numbers of bowel sounds in health subjects were 5.6 ± 2.3/min. The numbers of bowel sounds in SAP patients at day 1,3 and 7 were 2.3 ± 0.7/min, 1.7 ± 0.2/min and 3.1 ± 1.1/min, respectively;which were significantly lower than that in the control group （P 〈 0.01）. The level of 5-HT in the control group was（86.7 ± 9.5）ng/ml, while the levels of 5-HT in the SAP patients at day 1, 3 and 7 were （112.0 ± 17.8） ng/ml, （130.5 ± 19.7） ng/ml, （107.9 ± 16.3） ng/ml. The level of urine iFABP in the control group was （90.5 ± 19.8） pg/ml, while the levels of urine iFABP in the SAP patients were （1250.2 ± 425.3） pg/ml, （1586.9 ± 523.4） pg/ml, （1154.6 ± 394.0） pg/ml. The levels of 5-HT and urine iFABP in the SAP patients all were significantly higher than those in the control group （P 〈0.01）. The levels of 5-HT and urine iFABP in the SAP patients at day 3 were significantly higher than those in the day 1 and day 7, while there was no significant difference between the two groups. Conclusions Determination of serum 5-HT and urine iFABP in patients with early SAP could effectively evaluate the intestinal function, and it may have potential clinical significance.