Diagnostic value of high mobility group protein B1 combined with intestinal fatty acid binding protein in neonatal necrotizing enterocolitis

doi:10.3877/cma.j.issn.1674-0793.2020.02.008

Abstract

Abstract:

Objective

To explore the value of combined detection of high mobility group protein B1 (HMGB1) and intestinal fatty acid binding protein (I-FABP) in the diagnosis of necrotizing enterocolitis (NEC) in neonates.

Methods

From July 2016 to July 2018, one hundred and nineteen NEC neonators (NEC group) admitted to Northwest Women and Children’s Hospital and 30 non-NEC neonators during the same period (control group) were selected. Enzyme linked immunosorbent assay (ELISA) was used to detect the protein expression levels of HMGB1 in stool samples and I-FABP protein expression levels in serum. ROC curve was used to analyze the diagnostic efficacy of single test and combined test for NEC.

Results

The expression levels of HMGB1 and I-FABP in children with Bell stage Ⅲ NEC were significantly higher than those in children with stage and Ⅱ NEC (P<0.05), the protein level showed a gradual upward trend with the aggravation of the disease. The levels of HMGB1 and I-FABP protein in NEC group were significantly higher than those in control group (P<0.05). The sensitivity, specificity and area under ROC curve were 89.60%, 86.50% and 0.985 (P<0.01), respectively, and the diagnostic efficiency of the two combined indicators was significantly higher (P<0.05).

Conclusions

The combined detection of HMGB1 and I-FABP has high sensitivity and specificity in the diagnosis of neonatal NEC. Real-time dynamic determination of HMGB1 and I-FABP is helpful for early screening and treatment of suspected NEC neonates and judgment of disease.

Key words: Enterocolitis, necrotizing, High mobility group proteins, Fatty acid-binding proteins, Joint detection

Ruogu Luo, Jingru Zhao, Quan Xu, Shiqi Liu, Pengliang Zhao. Diagnostic value of high mobility group protein B1 combined with intestinal fatty acid binding protein in neonatal necrotizing enterocolitis[J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(02): 111-114.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2020.02.008

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2020/V14/I02/111

Figures/Tables 4

References 14

[1]	陈发玲，徐伟珏，李龙至, 等. 不同病变范围新生儿坏死性小肠结肠炎手术干预效果分析[J]. 中华实用儿科临床杂志, 2016, 31(23): 1783-1786.
[2]	Neu J, Walker WA. Necrotizing enterocolitis[J]. N Engl J Med, 2011, 364(3): 255-264.
[3]	Ockner RK, Manning JA. Fatty acid-binding protein in small intestine. Identification, isolation, and evidence for its role in cellular fatty acid transport[J]. J Clin Invest, 1974, 54(2): 326-338.
[4]	Heida FH, Hulscher JB, Schurink M, et al. Intestinal fatty acid-binding protein levels in necrotizing enterocolitis correlate with extent of necrotic bowel: results from a multicenter study[J]. J Pediatr Surg, 2015, 50(7): 1115-1118.
[5]	Vitali R, Stronati L, Negroni A, et al. Fecal HMGB1 is a novel marker of intestinal mucosal inflammation in pediatric inflammatory bowel disease[J]. Am J Gastroenterol, 2011, 106(11): 2029-2040.
[6]	李蕊. 新生儿坏死性小肠结肠炎研究进展[C]//中华医学会,中华医学会儿科分会. 中华医学会第十八次全国儿科学术会议论文汇编,长沙, 2013.
[7]	邵肖梅，叶鸿瑁，丘小汕. 实用新生儿学[M]. 北京: 人民卫生出版社, 2011.
[8]	宾广智，杨宇. 新生儿坏死性小肠结肠炎病原学检测及药敏分析[J]. 生物技术世界, 2014, 1(12): 107.
[9]	田云粉，李利，米弘瑛, 等. 肠型脂肪酸结合蛋白和粪钙卫蛋白联合检测在足月新生儿坏死性小肠结肠炎中的应用价值[J]. 中国当代儿科杂志, 2016, 18(11): 1080-1083.
[10]	秦嘉丽，韦红，李禄全, 等. 血清肠型脂肪酸结合蛋白在诊断新生儿坏死性小肠结肠炎中的意义[J]. 中华小儿外科杂志, 2013, 34(8): 590-594.
[11]	王俊平，刘颖，余东玲, 等. 血清肠型脂肪酸结合蛋白联合血清淀粉样蛋白A诊断重症新生儿坏死性小肠结肠炎应用价值研究[J]. 中国实用儿科杂志, 2017, 32(11): 838-841.
[12]	Guthmann F, Börchers T, Wolfrum C, et al. Plasma concentration of intestinal- and liver-FABP in neonates suffering from necrotizing enterocolitis and in healthy preterm neonates[J]. Mol Cell Biochem, 2002, 239(1-2): 227-234.
[13]	Schurink M, Kooi EM, Hulzebos CV, et al. Intestinal fatty acid-binding protein as a diagnostic marker for complicated and uncomplicated necrotizing enterocolitis: A prospective cohort study[J]. PLoS One, 2015, 10(3): e0121336.
[14]	路勇明. 新生儿坏死性小肠结肠炎发病危险因素及血清肠脂肪酸结合蛋白在其早期诊断的临床价值[J]. 中外医学研究, 2016, 14(19): 113-114.

组别	例数	日龄(d)	性别(男/女,例)	胎龄(W)	出生体质量(kg)
NEC组	119	2~25(13.48±5.17)	70/49	29~42(34.55±4.67)	1.30~2.60(1.95±0.62)
对照组	30	1~24(12.79±4.88)	8/22	30~41(36.14±4.82)	1.25~2.53(1.86±0.57)
统计值	?	t=2.890	χ²=3.001	t=3.255	t=1.339
P值	?	0.073	0.062	0.058	0.182

组别	例数	日龄(d)	性别(男/女,例)	胎龄(W)	出生体质量(kg)
NEC组	119	2~25(13.48±5.17)	70/49	29~42(34.55±4.67)	1.30~2.60(1.95±0.62)
对照组	30	1~24(12.79±4.88)	8/22	30~41(36.14±4.82)	1.25~2.53(1.86±0.57)
统计值	?	t=2.890	χ²=3.001	t=3.255	t=1.339
P值	?	0.073	0.062	0.058	0.182

组别		例数	入院时	入院第1天	入院第4天	入院第7天	F值	P值
NEC组		119	?	?	?	?	?	?
?	Ⅰ期	43	11.78±1.55^a	14.05±2.89^a	20.97±4.51^a	32.79±6.78^a	3.402	0.029
?	Ⅱ期	56	13.75±3.12^a	18.82±6.57^a	27.66±9.20^a	42.05±9.57^a	3.966	0.025
?	Ⅲ期	20	21.63±5.09^a	27.42±5.14^a	34.58±7.34^a	48.66±13.52^a	4.701	0.016
对照组		30	4.75±1.32	4.95±1.23	5.39±1.31	5.23±1.21	?	?

组别		例数	入院时	入院第1天	入院第4天	入院第7天	F值	P值
NEC组		119	?	?	?	?	?	?
?	Ⅰ期	43	11.78±1.55^a	14.05±2.89^a	20.97±4.51^a	32.79±6.78^a	3.402	0.029
?	Ⅱ期	56	13.75±3.12^a	18.82±6.57^a	27.66±9.20^a	42.05±9.57^a	3.966	0.025
?	Ⅲ期	20	21.63±5.09^a	27.42±5.14^a	34.58±7.34^a	48.66±13.52^a	4.701	0.016
对照组		30	4.75±1.32	4.95±1.23	5.39±1.31	5.23±1.21	?	?

组别		例数	入院时	入院第1天	入院第4天	入院第7天	F值	P值
NEC组		119	?	?	?	?	?	?
?	Ⅰ期	43	3.89±1.98^a	5.07±2.36^a	4.09±2.14^a	4.03±1.89^a	2.893	0.044
?	Ⅱ期	56	4.42±2.57^a	6.87±2.74^a	5.17±2.25^a	4.76±2.08^a	3.130	0.036
?	Ⅲ期	20	5.89±2.92^a	8.15±2.91^a	6.21±2.83^a	5.17±2.29^a	3.996	0.031
对照组		30	2.09±0.85	2.25±0.84	2.17±0.79	2.23±0.82	-	-

Please choose a citation manager

Content to export