肠脂肪酸结合蛋白及降钙素原联合测定在外伤性肠破裂早期诊断中的应用

Application of intestinal fatty acid binding protein and blood procalcitonin for diagnosis of traumatic intestinal rupture in early stage

目的探讨肠脂肪酸结合蛋白（IFABP）及降钙素原（PCT）联合测定对外伤性肠破裂早期诊断价值。方法回顾性分析2012年5月～2016年4月泰州市人民医院收治的腹部外伤患者58例，其中肠破裂21例（肠破裂组），非肠破裂37例（非肠破裂组），分别在不同时段测定IFABP及PCT水平，对两组患者血清学结果进行动态比较分析。结果外伤性肠破裂组IFABP及PCT水平明显高于非肠破裂组，肠破裂组IFABP及PCT水平术后明显下降，入院时、入院后4h、术前、术后24hIFABP及PCT水平比较差异具有统计学意义（P〈0．05）；72h比较差异无统计学意义（P〉0．05）。同时发现采用两者联合检测，准确率92．4％，敏感性96．3％，特异度72．8％，明显高于IFABP及PCT单独测定。结论联合、动态测定血浆中IFABP及血PCT水平对外伤性肠破裂有早期诊断价值，具有临床意义。

Objective To investigate the role of intestinal fatty acid binding protein （IFABP） and blood procalcitonin （PCT） in diagnosis of traumatic Intestinal rupture in early stage. Methods The clinical data of 58 patients with abdominal injuries admitted from May 2012 to April 2016 were retrospectively analyzed. All 58 patients were divided into intestinal rupture group （ n = 21 ） and non- intestinal rupture group （ n = 37 ）. The concentrations of IFABP and PCT were detected, analyzed and compared between two groups at different intervals. Results The IFABP and PCT in intestinal rupture group were significantly higher than those in non-intestinal rupture group. The IFABP and PCT in intestinal rupture group significantly decreased after operations. There were significantly differences in IFABP and PCT between two groups at admission, 4 hours after admission, preoperative period, and 24 hours after operation. However, these differences disappeared at 72 hours after operation. At the same time, the accuracy tale 92.4%, sensitivity 96. 3%, specificity 72. 8% found in combination of these two biomarkers were significantly higher than those of IFABP and PCT measured separately. Conclusions The combination of IFABP and PCT detection can be used as an indicator for the diagnosis of traumatic intestinal rupture in the early stage.