肠型脂肪酸结合蛋白、Toll样受体4、肠三叶因子与脑卒中患者胃肠功能障碍的相关性研究

The correlation between IFABP,TLR4,ITF and the occurrence of gastrointestinal dysfunction in patients with stroke

目的分析肠型脂肪酸结合蛋白(intestinal fatty acid-binding protein,IFABP)、Toll样受体4(Toll-like receptor 4,TLR4)、肠三叶因子(intestinal trefoil factor,ITF)与脑卒中患者胃肠功能障碍的相关性。方法根据患者入院7d内是否出现胃肠功能障碍将68例脑卒中患者分为对照组(无胃肠功能障碍,n=41)和观察组(出现胃肠功能障碍,n=27)。比较两组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分以及IFABP、TLR4、ITF水平。统计两组患者预后良好率;使用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析IFABP、TLR4、ITF水平在预估脑卒中患者胃肠功能障碍发生和不良预后的价值。结果与对照组比较,观察组NIHSS评分以及IFABP、TLR4、ITF水平均较高(P<0.05)。观察组预后良好率(55.56%)较对照组(78.05%)低(P<0.05);IFABP、TLR4、ITF水平预测脑卒中患者胃肠功能障碍发生的最佳临界值为IFABP≥367.85μg/L、TLR4≥3.78ng/ml、ITF≥14.40μg/L,此时曲线下面积为0.851、0.838、0.744(P<0.05),灵敏度为77.78%、70.37%、77.78%,特异度为92.68%、92.68%、75.61%。IFABP、TLR4、ITF水平预测脑卒中患者不良预后的最佳临界值为IFABP≥336.10μg/L、TLR4≥3.05ng/ml、ITF≥15.95μg/L,此时曲线下面积为0.914、0.925、0.930(P<0.05),灵敏度为100.00%、100.00%、76.19%,特异度为70.21%、65.96%、95.74%。结论存在胃肠功能障碍的脑卒中患者NIHSS评分以及IFABP、TLR4、ITF水平均较高,且不良预后发生风险较高,检测脑卒中患者IFABP、TLR4、ITF水平可了解胃肠功能障碍发生风险和不良预后发生风险。

Objective To analyze the correlation of intestinal fatty acid-binding protein(IFABP),Toll-like receptor 4(TLR4),intestinal trefoil factor(ITF)and the occurrence of gastrointestinal dysfunction in patients with stroke.Methods According to the presence or absence of gastrointestinal dysfunction within 7 days of admission,68 patients with stroke were divided into a control group(without gastrointestinal dysfunction,n=41)and an observation group(with gastrointestinal dysfunction,n=27).The National Institutes of Health Stroke Scale(NIHSS)scores and the levels of IFABP,TLR4 and ITF were compared between the two groups.The good prognosis rate of the two groups was counted.Receiver operating characteristic(ROC)curve was used to analyze the value of IFABP,TLR4 and ITF levels in predicting the occurrence of gastrointestinal dysfunction and poor prognosis in patients with stroke.Results Compared with the control group,the NIHSS score and the levels of IFABP,TLR4 and ITF in the observation group were higher(P<0.05).The good prognosis rate of the observation group was lower than that of the control group(55.56%vs.78.05%,P<0.05).The optimal critical values of IFABP,TLR4 and ITF for predicting gastrointestinal dysfunction in stroke patients were IFABP≥367.85μg/L,TLR4≥3.78 ng/ml and ITF≥14.40μg/L,respectively.And the area under the curve was 0.851,0.838 and 0.744(P<0.05),respectively.The sensitivity was 77.78%,70.37%,77.78%,respectively,and the specificity was 92.68%,92.68%,75.61%,respectively.The optimal critical values of IFABP,TLR4 and ITF for predicting poor prognosis of stroke patients were IFABP≥336.10μg/L,TLR4≥3.05ng/ml,ITF≥15.95μg/L,respectively.And the area under the curve was 0.914,0.925,0.930(P<0.05),respectively.The sensitivity was 100.00%,100.00%,76.19%,respectively,and the specificity was 70.21%,65.96%,95.74%,respectively.Conclusions The NIHSS score,IFABP,TLR4 and ITF levels are higher in stroke patients with gastrointestinal dysfunction,and the risk of poor prognosis is higher.Detection of IFABP,TLR4 and ITF levels in stroke patients can predict the risk of gastrointestinal dysfunction and poor prognosis.