【摘要】 目的研究危重症新生儿血清二胺氧化酶(DAO)和肠脂肪酸结合蛋白(I-FABP)的变化及临床意义。方法于2013年10月~2014年10月在新疆石河子大学医学院第一附属医院儿科NICU收治的新生儿,根据新生儿危重病例评分(NCIS)分为危重组41例和极危重组14例,其中危重组和极危重组的55例新生儿作为研究组,根据有无胃肠功能障碍分为有胃肠功能障碍组(有胃障组)34例和无胃肠功能障碍组(无胃障组)21例,依据1995年全国危重病会议制定的标准,有胃障组又分为轻度胃障组22例、重度胃障组12例;选取同期正常新生儿30例为对照组,分别检测其血清DAO、I-FABP水平。比较各组新生儿血清DAO、I-FABP水平的变化。结果危重症新生儿血清DAO与I-FABP水平均明显高于正常对照组,差异有统计学意义(P<0.01);有胃障组血清DAO与I-FABP水平较无胃障组、对照组明显升高,差异有统计学意义(P<0.01);随着危重程度的增加,新生儿血清DAO与I-FABP水平显著上升,差异有统计学意义(P<0.01);在危重症患儿中轻度胃障组与重度胃障组血清DAO与I-FABP水平比较差异无统计学意义(P>0.05)。结论血清DAO与I-FABP水平与胃肠功能障碍呈正相关,二者有很好的相关性,可作为危重症新生儿早期胃肠功能障碍早期诊断敏感指标之一;可用来指导危重患儿的临床分度,指导治疗;并对判断危重症新生儿病情、进展及预后有重要意义。更多还原

【Abstract】 Objective To research the changes and clinical significance of serum diamineoxidase and intestinal fatty acid binding protein( I- FABP). Methods Fifty- five neonates treated in NICU in the hospital from October 2013 to October 2014 were selected as study group,then they were divided into critical group( 41 neonates) and extremely critical group( 14 neonates) according to neonatal critical illness score( NCIS); the 55 neonates were also divided into gastrointestinal dysfunction group( 34 neonates) and non- gastrointestinal dysfunction group( 21 neonates) according to the presence or absence of gastrointestinal dysfunction. According to the standards formulated in National Critical Disease Conference in 1995,the neonates in gastrointestinal dysfunction group were divided into mild gastrointestinal dysfunction group( 22 neonates) and severe gastrointestinal dysfunction group( 12 neonates); 30 normal neonates were selected during the same period as control group; the levels of serum diamineoxidase and I- FABP were detected; the changes of serum diamineoxidase and I- FABP levels were compared among different groups. Results The levels of serum diamineoxidase and I- FABP in critical neonates were statistically significantly higher than those in normal control group( P < 0. 01); the levels of serum diamineoxidase and I- FABP in gastrointestinal dysfunction group were statistically significantly higher than those in non- gastrointestinal dysfunction group and control group( P < 0. 01);the levels of serum diamineoxidase and I- FABP increased significantly with aggravation of the diseases,there were statistically significant differences( P < 0. 01); there was no statistically significant difference in the levels of serum diamineoxidase and I- FABP between mild gastrointestinal dysfunction group and severe gastrointestinal dysfunction group( P > 0. 05). Conclusion The levels of serum diamineoxidase and I- FABP were positively correlated with gastrointestinal dysfunction,there was a good correlation,diamineoxidase and I- FABP can be used as sensitive indexes for early diagnosis of early gastrointestinal dysfunction in critically ill neonates; diamineoxidase and I-FABP can be used to direct clinical grading and treatment; which have important significance in judging the condition of patients,progression,and prognosis of the disease.更多还原