肠型脂肪酸结合蛋白应用于重症急性胰腺炎胃肠道功能及病情评估的研究

Application of intestinal fatty acid binding protein in the evaluation of gastrointestinal function and condition in severe acute pancreatitis

目的探讨肠型脂肪酸结合蛋白(I-FABP)在重症急性胰腺炎(SAP)患者胃肠道功能障碍严重程度以及病情评估中的意义。方法选取2016年12月至2018年12月青岛市第八人民医院收治的34例SAP患者,收集入院时患者血清I-FABP、降钙素原(PCT)、C反应蛋白(CRP)浓度以及白细胞计数等临床资料,并进行胃肠功能障碍程度评分以及急性生理与慢性健康状况(APACHEⅡ)评分,将以上指标与I-FABP质量浓度进行相关性分析。结果入院时I-FABP浓度为(551±204)ng/L,PCT浓度为(3.36±1.79)μg/L,CRP浓度为(171±73)mg/L,白细胞计数为(14.47±4.09)×10^9/L,APACHE Ⅱ评分为(12±5)分,胃肠道功能障碍评分为(10±2)分。患者血清I-FABP浓度和入院时PCT、CRP浓度、白细胞计数、APACHEⅡ评分、胃肠道功能评分均呈正相关关系(P<0.01),r分别为0.537、0.662、0.730、0.716、0.686。结论血清I-FABP与血清炎性指标、APACHEⅡ评分和胃肠道功能评分存在相关性,有助于评估SAP患者的胃肠功能障碍及疾病严重程度。

Objective To study the significance of intestinal fatty acid binding protein (I-FABP) in the severity of gastrointestinal dysfunction and the assessment of disease severity in severe acute pancreatitis (SAP) patients.Methods From December 2016 to December 2018,thirty-four patients with SAP admitted to Qingdao Eighth People’s Hospital were selected.Levels of serum I-FABP,procalcitonin (PCT),C-reactive protein (CRP) and white blood cell count were collected at admission.The patients were scored for gastrointestinal dysfunction and Acute Physiological and Chronic Health Status Score Ⅱ (APACHEⅡ).The correlations between serum I-FABP level and the above markers were analyzed.Results The concentration of I-FABP at admission was (551±204) ng/L,the PCT concentration was (3.36±1.79) μg/L,the CRP concentration was (171±73) mg/L,and the white blood cell count was (14.47±4.09)×10^9/L,APACHE Ⅱ score was (12±5),and gastrointestinal function score was (10±2).There was positive correlation among the serum I-FABP concentration and the concentration of PCT,CRP,white blood cell count,APACHEⅡ score,and gastrointestinal function score (P<0.01),and r was 0.537,0.662,0.730,0.716,and 0.686 respectively.Conclusion Serum I-FABP is correlated with serum inflammatory markers,APACHE Ⅱ and gastrointestinal function score,which is helpful to evaluating gastrointestinal dysfunction and severity of SAP.