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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。
Objective To study the changes and clinical significance of serum diamine oxidase (DAO) and intestinal fatty acid binding protein (I-FABP) in critically ill neonates. Methods From October 2013 to October 2014, newborns admitted to Pediatric NICU of First Affiliated Hospital of Shihezi University School of Medicine in Xinjiang were divided into critical group (n = 41) and critically endangered (n = 14) according to Neonatal Critical Illness Scale (NCIS) Among them, 55 newborns in critically ill and critically ill patients were divided into study group (34 patients with gastrointestinal dysfunction group and non-gastrointestinal dysfunction group) Group) 21 cases, according to the criteria set by the 1995 National Critical Care Conference, there are 22 cases of gastric barrier group with mild gastric barrier and 12 cases of severe gastric barrier group; 30 normal neonates were selected as the control group, respectively Serum DAO, I-FABP levels were measured. The changes of serum DAO and I-FABP in each group were compared. Results Serum levels of DAO and I-FABP in critically ill neonates were significantly higher than those in normal controls (P <0.01). Serum levels of DAO and I-FABP in patients with gastric disturbances were significantly higher than those in patients without gastric barriers and controls (P <0.01). The levels of DAO and I-FABP in neonates increased significantly with the increase of the severity of the disease, the difference was statistically significant (P <0.01). In the critically ill children There was no significant difference in the levels of DAO and I-FABP between mild and advanced gastric block group (P> 0.05). Conclusions The serum levels of DAO and I-FABP are positively correlated with gastrointestinal dysfunction. Both of them have good correlation, which can be used as one of the sensitive indicators of early diagnosis of early gastrointestinal dysfunction in critically ill newborns. It can be used to guide the critically ill children Clinical indexing, guiding treatment; and judging critical illness neonates, progress and prognosis of great significance.