肠型脂肪酸结合蛋白在危重症患者预后评估中的价值

doi:10.3969/j.issn.1673-8640.2022.02.007

摘要/Abstract

摘要：

目的探讨肠型脂肪酸结合蛋白（IFABP）在危重症患者预后评估中的价值。方法选取危重症患者123例,收集所有患者入院24 h内的一般资料,包括年龄、性别、基础疾病、快速序贯器官功能衰竭评分（qSOFA）,根据28 d转归情况分为存活组（95例）和死亡组（28例）,以健康体检者35名作为正常对照组。检测所有对象IFABP和C反应蛋白（CRP）水平。采用受试者工作特征（ROC）曲线评价各项指标判断危重症患者28 d死亡的效能。采用二分类变量多因素Logistic回归分析筛选危重症患者28 d死亡的危险因素。结果死亡组、存活组、正常对照组血清IFABP和CRP水平均逐渐降低（P<0.05）。ROC曲线分析结果显示,IFABP、CRP和qSOFA评分判断危重症患者死亡的曲线下面积（AUC）分别为0.865、0.750、0.808。Logistic回归分析结果显示,IFABP≥36.20 ng/mL、CRP≥36.82 mg/L和qSOFA评分≥2.0分是危重症患者28 d死亡的危险因素[比值比（OR）值分别为10.668、3.775、9.048,95%可信区间（CI）分别为3.498~32.533、1.156~12.325、1.818~45.038]。结论 IFABP水平升高提示危重症患者死亡风险增加,或可作为危重症患者28 d死亡的有效预测指标。

关键词: 肠型脂肪酸结合蛋白, 危重症, 预后

Abstract:

Objective To investigate the prognostic role of intestinal fatty acid binding protein（IFABP） in critically ill patients. Methods A total of 123 critically ill patients were enrolled,and the clinical data,including age,sex,basic diseases and quick sequential organ failure assessment（qSOFA） score,were recorded within 24 h of admission. According to the outcome of 28 d,they were classified into survival group（95 cases） and death group（28 cases）. Totally,35 healthy subjects were enrolled as control group. IFABP and C-reactive protein（CRP） levels were determined. The efficacy of each index was evaluated by receiver operating characteristic（ROC） curve,and the risk factors of death in critically ill patients were screened by multivariate Logistic regression analysis of binary variables. Results The levels of serum IFABP and CRP in death group,survival group and control group decreased gradually（P<0.05）. ROC curve analysis showed that the areas under curves（AUC）of IFABP,CRP and qSOFA score in the mortality risk of critically ill patients were 0.865,0.750 and 0.808,respectively. Logistic regression analysis showed that IFABP≥36.20 ng/mL,CRP≥36.82 mg/L and qSOFA score≥2.0 were risk factors for death in critically ill patients [odds ratios（OR） were 10.668,3.775 and 9.048,95% confidence intervals（CI） were 3.498-32.533,1.156-12.325 and 1.818-45.038,respectively]. Conclusions IFABP may be an effective predictor of mortality risk in critically ill patients,and its increase may indicate the risk of death in critically ill patients.

Key words: Intestinal fatty acid binding protein, Critical illness, Prognosis

中图分类号:

446.1

刘吉纯, 张艳菊. 肠型脂肪酸结合蛋白在危重症患者预后评估中的价值[J]. 检验医学, 2022, 37(2): 130-133.

LIU Jichun, ZHANG Yanju. Prognostic role of intestinal fatty acid-binding protein in critically ill patients[J]. Laboratory Medicine, 2022, 37(2): 130-133.

图/表 4

参考文献 14

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组别	例数	糖尿病/例	COPD/例	入住ICU/例	qSOFA评分/分	CRP/（mg/L）	IFABP/（ng/mL）
死亡组	28	8	3	20	2.3±0.5	54.4±24.7	47.6±19.7
存活组	95	19	14	35	1.5±0.6	34.4±13.7	26.1±9.3
正常对照组	35					9.9±4.3	12.1±7.3
统计值		0.927	0.294	10.500	6.200	70.100	74.800
P值		0.435	0.760	0.002	0.000	0.000	0.000

组别	例数	糖尿病/例	COPD/例	入住ICU/例	qSOFA评分/分	CRP/（mg/L）	IFABP/（ng/mL）
死亡组	28	8	3	20	2.3±0.5	54.4±24.7	47.6±19.7
存活组	95	19	14	35	1.5±0.6	34.4±13.7	26.1±9.3
正常对照组	35					9.9±4.3	12.1±7.3
统计值		0.927	0.294	10.500	6.200	70.100	74.800
P值		0.435	0.760	0.002	0.000	0.000	0.000

项目	AUC（95%CI^①）	最佳临界值	敏感性/%	特异性/%	Youden指数
IFABP	0.865（0.793~0.936）	36.20 ng/mL	71.4	84.0	0.6
CRP	0.750（0.647~0.853）	36.82 mg/L	78.6	58.0	0.4
qSOFA评分	0.808（0.732~0.885）	2.0分	100.0	55.0	0.5

项目	AUC（95%CI^①）	最佳临界值	敏感性/%	特异性/%	Youden指数
IFABP	0.865（0.793~0.936）	36.20 ng/mL	71.4	84.0	0.6
CRP	0.750（0.647~0.853）	36.82 mg/L	78.6	58.0	0.4
qSOFA评分	0.808（0.732~0.885）	2.0分	100.0	55.0	0.5

项目	β值	标准误	Wald值	P值	OR值（95%CI）
IFABP	2.367	0.569	17.314	0.000	10.668（3.498~32.533）
CRP	1.329	0.604	4.843	0.028	3.775（1.156~12.325）
qSOFA评分	2.203	0.819	7.235	0.007	9.048（1.818~45.038）