肠脂肪酸结合蛋白联合NLR、PCT检测对小儿绞窄性肠梗阻的诊断价值

Diagnostic Value of Intestinal Fatty Acid Binding Protein Combined with NLR and PCT in Diagnosis of Strangulated Intestinal Obstruction in Children

【目的】探讨肠脂肪酸结合蛋白(IFABP)联合中性粒细胞与淋巴细胞比值(NLR)、降钙素原(PCT)检测对小儿绞窄性肠梗阻的诊断价值。【方法】以两院收治的96例肠梗阻患儿作为观察组,另选取同期来医院体检的84例健康小儿为对照组。比较两组对象的血清IFABP、NLR、PCT水平。统计绞窄性肠梗阻患儿的发生情况,比较绞窄性肠梗阻患儿与单纯肠梗阻患儿的临床特征,采用Logistic多元回归分析影响绞窄性肠梗阻发生的因素,采用受试者工作特征(ROC)曲线分析血清IFABP联合NLR、PCT水平诊断小儿绞窄性肠梗阻的价值。【结果】观察组患儿血清IFABP、NLR、PCT水平均高于对照组(P<0.05);96肠梗阻患儿中绞窄性肠梗阻的发生率为43.75%(42/96)。绞窄性肠梗阻患儿腹膜刺激征、腹部手术史构成比及血清IFABP、NLR、PCT水平均高于单纯肠梗阻患儿,且差异有统计学意义(P<0.05)。Logistic多因素回归分析显示:血清IFABP、NLR、PCT水平及腹部手术史均是小儿发生绞窄性肠梗阻的独立危险因素(P<0.05);ROC分析显示,血清IFABP、NLR、PCT水平诊断小儿绞窄性肠梗阻的最佳截断点分别为375.80 pg/mL、3.82 ng/mL、0.34 ng/mL,曲线下面积(AUC)分别为0.818、0.786、0.821,联合诊断时特异度和AUC均最高。【结论】绞窄性肠梗阻患儿血清IFABP、NLR、PCT水平均异常升高,其均可作为诊断小儿绞窄性肠梗阻的敏感指标,且联合诊断时价值更高。

【Objective】This study aimed to explore the diagnostic value of intestinal fatty acid-binding protein(IFABP)combined with neutrophil-to-lymphocyte ratio(NLR)and procalcitonin(PCT)testing in pediatric strangulated intestinal obstruction.【Methods】Ninety-six cases of intestinal obstruction in children admitted to two hospitals were enrolled as the observation group,and 84 healthy children undergoing medical examinations during the same period were selected as the control group.Serum levels of IFABP,NLR,and PCT were compared between the two groups.The occurrence of strangulated intestinal obstruction was recorded,and the clinical characteristics of children with strangulated intestinal obstruction were compared with those of children with simple intestinal obstruction.Logistic regression analysis was used to determine the factors influencing the occurrence of strangulated intestinal obstruction,and receiver operating characteristic(ROC)analysis was performed to evaluate the diagnostic value of serum IFABP combined with NLR and PCT levels in pediatric strangulated intestinal obstruction.【Results】The serum levels of IFABP,NLR,and PCT in the observation group were significantly higher than those in the control group(P<0.05).The incidence of strangulated intestinal obstruction among the 96 cases of intestinal obstruction was 43.75%(42/96).Children with strangulated intestinal obstruction had a higher incidence of peritoneal irritation signs,history of abdominal surgery,and elevated serum levels of IFABP,NLR,and PCT compared to those with simple intestinal obstruction;And the differences were statistically significant(P<0.05).Logistic regression analysis showed that serum levels of IFABP,NLR,PCT,and history of abdominal surgery were independent risk factors for pediatric strangulated intestinal obstruction(P<0.05).ROC analysis indicated that the optimal cutoff points for serum IFABP,NLR,and PCT levels in diagnosing pediatric strangulated intestinal obstruction were 375.80 pg/mL,3.82 ng/mL,and 0.34 ng/mL,respectively,with corresponding area under the curve(AUC)values of 0.818,0.786,and 0.821.The combination of these markers yielded the highest specificity and AUC in diagnostic performance.【Conclusion】Children with strangulated intestinal obstruction exhibit elevated serum levels of IFABP,NLR,and PCT,which can serve as sensitive indicators for diagnosing pediatric strangulated intestinal obstruction.Furthermore,their diagnostic value is enhanced when used in combination.