To Explore The Kinetisis Of Serum IFABP And LFABP In Intestinal Ischemia Of Chidren Patients

Objective:To investigate the kinetisis of serum intestinal fatty acid-binding protein (IFABP), liver fatty acid-binding protein(LFABP),D-lactate(D-LA) and creatine kinase(CK) levels in children patients suffering intestinal ischemia in order to explore the change of these markers in different phases of intestinal ischemia, then evaluate their significance to diagnose intestinal ischemia of children patients.Methods:Three experimental groups(EG) of children intestinal ischemia patients were consecutively selected after ward admission:patients with intestinal necrosis and subjected enterectomy with anastomosis (n=11);patients with intestinal ischemia and subjected only celiotomy (n=23);patients with intestinal ischemia but not subjected operation(n=12); 10 patients with appendicitis were served as EG4 and 10 healthy children as the control group(CG). Venous blood was collected from CG for once,and from EGs on admission,1st and 3rd day respectively after operation (or effectively therapied).The concentration of serum IFABP,LFABP,D-LA and CK were measured.Results:1.Compared with the CG,the IFABP levels in all the intestinal ischemia EGs were increased obviously on admission,and were highest in the intestinal necrosis group,and positively correlate with the length of diseased intestine (r=0.894, P<0.001). Subsequently, the IFABP levels decreased or recovered to normal on the 1st day after operation(or effectively therapied) in the intestinal ischemia EGs,and on the 3rd day the IFABP levels were not obviously different with the levels on the 1st day. In the appendicitis group,no matter preopetation or postopetation the IFABP levels were no diversity compared with CG.2.Compared with the CQthe LFABP levels in all the intestinal ischemia EGs were increased obviously on admission,the LFABP levels in EG1 and EG2 were higher than the level in EG3. The levels between EG1 and EG2 were not obviously different. Subsequently, the LFABP levels decreased or recovered to normal on the 1st day after operation(or effectively therapied) in the intestinal ischemia EGs,and on the 3rd day the LFABP levels were not obviously different with the levels on the 1st day. In the appendicitis group,no matter preopetation or postopetation the LFABP levels were no diversity compared with CG.3.Compared with the CQthe D-LA levels in all the EGs were increased obviously on admission,and were highest in the intestinal necrosis group,and positively correlate with the length of diseased intestine (r=0.602, P＜0.001). Subsequently, the D-LA levels were not changed on the 1st day after operation(or effectively therapied) i,and on the 3rd day the D-LA levels only had little decrease in the EGs compared with the levels on admission,yet compared with CQthe levels still were high.4.The CK level in the EG1 increased obviously compared with CG on admission,after operation,the level gradually decrease,yet still higher than the level of the CG even on the 3rd day. In other EGs,whenever we measured it, the CK levels were no diversity compared with CG.Conclution:1.IFABP is a sensitive,specific marker to detect intestinal ischemia, and has positive correlation with the extent of diseased intestine,and it is not prone to be impacted by intestinal inflammation and abdomen surgery.2.LFABP is sensitiver to detect intestinal ischemia than the IFABP,and is also not prone to be impacted by intestinal inflammation and abdomen surgery.3.D-LA is a sensitive marker to detect intestinal ischemia,and has positive correlation with the extent of diseased intestine,yet after ischemia was removed,the D-LA level still is high,and it is apt to be impacted by intestinal inflammation.4.CK has little significance to detect prophase of intestinal ischemia. But it's obvious leap in intestinal ischemia patients always sheds a light on necrosis.