肠脂肪酸结合蛋白和肌酸磷酸激酶在肠梗阻诊断中的意义

Diagnostic Value of Plasma Intestinal Fatty Acid-binding Protein and Creatine Kinase in Patients Subjected with Intestinal Obstruction

目的:探讨肠脂肪酸结合蛋白(IFABP)、肌酸磷酸激酶(CK)在肠梗阻诊断中的意义。方法:将27例肠梗阻患者分为两组:观察组1(手术发现肠坏死行肠切除、肠吻合术)12例,观察组2(行手术治疗发现无肠坏死者)15例,分别在入院时、术后第1 d、术后第3 d采静脉血,检测血标本中IFABP及CK的含量;正常体检者15例作为对照组,采静脉血1次。结果:两观察组入院时血清IFABP及CK水平均高于正常对照组;术后第1 d,两观察组IFABP水平均降至正常,CK水平较术前无明显变化;术后第3 d,两观察组IFABP水平与对照组无明显差别,而CK水平较前明显降低。结论:IFABP及CK是诊断肠缺血、肠坏死的敏感指标,且IFABP对肠梗阻术后的预后有指导意义。

Objective To explore the diagnostic value of plasma intestinal fatty acid-binding protein （IF- ABP） and creatine kinase（CK） in patients with intestinal obstruction. Methods Twenty-seven patients subject- ed with intestinal obstruction were consecutively selected as observational group （OG）, the 12 patients having en- terectomy were chosen as OG1, and the other 15 patients having celiotomy were chosen as OG2. Fifteen healthy adults were chosen as the control group（CG）. Venous blood was collected from CG for once, and from OG on ad- mission, first and 3rd day after operation respectively. The concentrations of serum IFABP and CK were mea- sured. Results Compared with the patients in CG, the IFABP and CK levels in both OG were increased obvi-ously on admission（P 〈 0.01）, and were higher in the intestinal necrosis group（P 〈 0.01）. Subsequently, the IFABP levels decreased to normal on 1st day after op-eration in the patients in OGs, but the CK levels had no variance. The IFABP levels were no difference in the two OGs on 3rd day of postoperation,and the CK levels were lower than those before operation. Conclusion Serum IFABP and CK are sensitive markers to detect intestinal ischemia or necrosis and the IFABP has guided significance to the prognosis of intestinal obstruction in patients who subjected operation.