Urinary intestinal fatty acid-binding protein concentration predicts extent of disease in necrotizing enterocolitis
Urinary intestinal fatty acid-binding protein concentration predicts extent of disease in necrotizing enterocolitis
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DOI：
10.1016/j.jpedsurg.2009.09.024
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发表时间：
2010-04-01
影响因子：
2.4
通讯作者：
Eaton, Simon
中科院分区：
文献类型：
--
作者：
Evennett, Nicholas J.;Hall, Nigel J.;Eaton, Simon
目的：尿肠脂肪酸结合蛋白（i-FABP）是肠粘膜细胞损伤的标志物，最近被提议作为早期检测坏死性小肠结肠炎（NEC）的临床有用措施。然而，尚无更晚期（贝尔 II/III 期）NEC 中尿 i-FABP 的数据。本研究的目的是测试尿液 i-FABP 在手术 NEC 中的使用。方法：每 24 小时从手术新生儿重症监护病房收治的贝尔 II/III 期 NEC 婴儿收集尿液。同时收集临床、实验室和手术数据。通过酶联免疫吸附测定对尿液 i-FABP 进行定量，并表示为皮克/纳摩尔肌酐（中位数[范围]）。结果以中位数（范围）表示，并通过 Mann-Whitney 检验和线性回归进行比较。结果：NEC 婴儿的 i-FABP:Cr 有增加的趋势（对照，1.0[0.4-1.3]，vs NEC，2.1[0.39-35.1]，P=.055）。尿 i-FABP：患有广泛疾病的婴儿 (7.4 pg/mmol [2.1-35.0 pg/mmol]) 的 Cr 显着高于患有局部疾病的婴儿 (1.1 pg/mmol [0.3-1.7 pg/mmol])，P=.002。此外，16 名患有 NEC 的婴儿中，有 6 名的 i-FABP: Cr 低于之前建议的 2 pg/mmol 临界值，其中 5 名患有局灶性疾病。尿 i-FABP：两次成功的非手术治疗期间 Cr 均下降（P
Purpose: Urinary intestinal fatty acid-binding protein (i-FABP), a marker of intestinal mucosal cell damage, has recently been proposed as a clinically useful measure in the early detection of necrotizing enterocolitis (NEC). However, there are no data on urinary i-FABP in more advanced (Bell stage II/III) NEC. The aim of this study was to test the use of urinary i-FABP in surgical NEC.Methods: Urine was collected every 24 hours from infants with Bell stage II/III NEC admitted to a surgical Neonatal Intensive Care Unit. Clinical, laboratory, and surgical data were collected concurrently. Urinary i-FABP was quantified by enzyme-linked immunosorbent assay and expressed as picograms per nanomole creatinine (median [range]). Results are presented as median (range) and compared by Mann-Whitney test and by linear regression.Results: There was a trend toward an increase in i-FABP:Cr in infants with NEC (controls, 1.0[0.4-1.3], vs NEC, 2.1[0.39-35.1], P=.055). Urinary i-FABP: Cr was significantly higher in infants with extensive disease (7.4 pg/mmol [2.1-35.0 pg/mmol]) than in those with focal disease (1.1 pg/mmol [0.3-1.7 pg/mmol]), P=.002. In addition, i-FABP: Cr was less than the previously suggested 2 pg/mmol cutoff in 6 of 16 infants with NEC, 5 of whom had focal disease. Urinary i-FABP: Cr decreased during both successful nonoperative management (P