Abstract 【Objective】This study aimed to explore the diagnostic value of intestinal fatty acid-binding protein (IFABP) combined with neutrophil-to-lymphocyte ratio (NLR) and procalcitonin (PCT) testing in pediatric strangulated intestinal obstruction. 【Methods】Ninety-six cases of intestinal obstruction in children admitted to two hospitals were enrolled as the observation group, and 84 healthy children undergoing medical examinations during the same period were selected as the control group. Serum levels of IFABP, NLR, and PCT were compared between the two groups. The occurrence of strangulated intestinal obstruction was recorded, and the clinical characteristics of children with strangulated intestinal obstruction were compared with those of children with simple intestinal obstruction. Logistic regression analysis was used to determine the factors influencing the occurrence of strangulated intestinal obstruction, and receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic value of serum IFABP combined with NLR and PCT levels in pediatric strangulated intestinal obstruction. 【Results】The serum levels of IFABP, NLR, and PCT in the observation group were significantly higher than those in the control group (P<0.05). The incidence of strangulated intestinal obstruction among the 96 cases of intestinal obstruction was 43.75% (42/96). Children with strangulated intestinal obstruction had a higher incidence of peritoneal irritation signs, history of abdominal surgery, and elevated serum levels of IFABP, NLR, and PCT compared to those with simple intestinal obstruction; And the differences were statistically significant (P<0.05). Logistic regression analysis showed that serum levels of IFABP, NLR, PCT, and history of abdominal surgery were independent risk factors for pediatric strangulated intestinal obstruction (P<0.05). ROC analysis indicated that the optimal cutoff points for serum IFABP, NLR, and PCT levels in diagnosing pediatric strangulated intestinal obstruction were 375.80 pg/mL, 3.82 ng/mL, and 0.34 ng/mL, respectively, with corresponding area under the curve (AUC) values of 0.818, 0.786, and 0.821. The combination of these markers yielded the highest specificity and AUC in diagnostic performance. 【Conclusion】Children with strangulated intestinal obstruction exhibit elevated serum levels of IFABP, NLR, and PCT, which can serve as sensitive indicators for diagnosing pediatric strangulated intestinal obstruction. Furthermore, their diagnostic value is enhanced when used in combination.
KOU Zhen-yu,CI Miao-miao. Diagnostic Value of Intestinal Fatty Acid Binding Protein Combined with NLR and PCT in Diagnosis of Strangulated Intestinal Obstruction in Children[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(7): 1002-1005.
[1] AL-ZUBAIDI M, BAYFIELD N, NEELANKAVIL S. Strangulated small bowel obstruction complicating totally extra-peritoneal laparoscopic inguinal hernia repair[J].BMJ Case Rep,2020, 13(2):232-241. [2] CALAME P, MALAKHIA A, TURCO C, et al. Transmural bowel necrosis from acute mesenteric ischemia and strangulated small-bowel obstruction:distinctive CT features [J].AJR Am J Roentgenol,2020, 214(1):90-95. [3] LOMG B, ROBERTSON J, KOYFMAN A. Emergency medicine evaluation and management of small bowel obstruction:evidence-based recommendations [J].J Emerg Med,2019, 56(2):166-176. [4] KITTAKA H, AKIMOTO H, TAKESHITA H, et al. Usefulness of intestinal fatty acid-binding protein in predicting strangulated small bowel obstruction[J].PLoS One,2014, 9(6):915-928. [5] 杜小雨, 艾亮. NLR、CRP及PCT在脓毒症新生儿中的变化及临床意义[J].实验与检验医学, 2019, 37(1):110-112. [6] MURASAKI M, NAKANISHI T, KANO KI, et al. Point-of-care procalcitonin may predict the need for surgical treatment in patients with small bowel obstruction [J].Am J Emerg Med,2020, 38(5):979-982. [7] 周永坤,许振国. 肠梗阻诊断治疗[M]. 北京:人民军医出版社, 2014:135-138. [8] 洪流. 消化外科病例精析[M].西安:第四军医大学出版社, 2014:92-94. [9] OZAWA M, ISHIBE A, SUWA Y, et al. A novel discriminant formula for the prompt diagnosis of strangulated bowel obstruction [J].Surg Today,2021, 36(1):23-40. [10] LIU W, SHI M Q. Multisection spiral CT in the diagnosis of adhesive small bowel obstruction:the value of CT signs in strangulation [J].Clin Radiol,2021, 76(1):5-11. [11] WU C, ZHU X, REN H, et al. Intestinal fatty acid-binding protein as a biomarker for the diagnosis of strangulated intestinal obstruction:A meta-analysis [J].Open Med (Wars),2021, 16(1):264-273. [12] 黄元林, 陈建洪. 肠脂肪酸结合蛋白及D-乳酸与急性肠梗阻预后的关系[J].海南医学, 2019, 30(22):114-116. [13] ETO S, KAWAHARA H, MATSUMOTO T, et al. Preoperative neutrophil-lymphocyte ratio is a predictor of bowel obstruction due to colorectal cancer growth [J].Anticancer Res,2019, 39(6):3185-3189. [14] 马超, 朱美意, 欧阳军. 肌酸激酶、D-二聚体等检验指标与肠道绞窄程度的相关性研究[J].中华灾害救援医学, 2018, 6(3):138-141.
2023, Vol. 40 
