高迁移率族蛋白B1联合肠型脂肪酸结合蛋白对新生儿坏死性小肠结肠炎的诊断价值

目的探究联合检测高迁移率族蛋白B1（HMGB1）、肠型脂肪酸结合蛋白（I-FABP）诊断新生儿坏死性小肠结肠炎（NEC）的价值。 方法选择2016年7月至2018年7月西北妇女儿童医院收治的NEC新生儿119例（NEC组）以及同期非NEC患儿30例（对照组）。运用酶联免疫吸附法（ELISA）检测患儿粪便样本中HMGB1蛋白以及血清中I-FABP蛋白的表达水平，ROC曲线分析单项检测与联合检测对NEC的诊断效能。 结果Bell Ⅲ期NEC患儿的HMGB1、I-FABP蛋白表达水平均显著高于Ⅰ、Ⅱ期患儿（P<0.05），随着病情加重，蛋白水平呈逐渐上升趋势。NEC组患儿HMGB1、I-FABP蛋白水平显著高于对照组，差异有统计学意义（P<0.05）。联合应用两项指标诊断NEC的敏感度为89.60%，特异度为86.50%，ROC曲线下面积为0.985（P<0.01），诊断效能明显高于单项检测（P<0.05）。 结论HMGB1、I-FABP联合检测诊断NEC患儿敏感度及特异度高，动态测定HMGB1、I-FABP指标水平，有助于疑似NEC新生儿的早期筛查、治疗以及病程进展的判断。

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

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 Ⅰ 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.