Zhang Lin, Fan Xiaoming, Zhong Zhiyue, Xu Guoxiong, Shen Jie
Emergency and Intensive Care Center for Chemical Accident, Jinshan Hospital affiliated to Fudan University, Shanghai, 201508, China.
Department of Gastroenterology, Jinshan Hospital of Fudan University, Shanghai, 201508, China.
Am J Emerg Med. 2015 Jul;33(7):867-71. doi: 10.1016/j.ajem.2015.01.047. Epub 2015 Feb 2.
The aim of this study was to describe the role of intestinal fatty acid-binding protein (iFABP) and allergy-related diamine oxidase (DAO) in patients with heat stroke (HS).
A total of 10 patients with HS in intensive care unit and 10 healthy volunteers were enrolled in this study. The plasma intestinal permeability markers iFABP and DAO were measured since the time of admission. The whole blood endotoxin was also assessed. The associations between iFABP, DAO, and endotoxin level were analyzed. Then, white blood cell count, procalcitonin, and C-reactive protein were examined. In addition, we also determined the levels of proinflammatory cytokines such as IL-1α, IL-6, and TNF-α.
Comparing with the healthy control, the plasma iFABP and DAO level in patients with HS increased significantly (P < .05). The kinetic curve showed that plasma iFABP and DAO level reached peak value at day 3 and day 4 after admission, respectively. The endotoxin level was positively correlated with iFABP and DAO level. We also observed a significantly increased level of procalcitonin and C-reactive protein but not white blood count in patients with HS. After treatment, the iFABP and DAO level decreased significantly (P < .05). A significant increase in level of IL-1α and IL-6 was also found in patients with HS.
The plasma concentrations of DAO and iFABP could reflect a better function of the intestinal mucosa barrier in patients with HS. Plasma iFABP and DAO level decreased significantly after the treatment and, thus, might be a predictor for the severity of HS.
本研究旨在描述肠道脂肪酸结合蛋白（iFABP）和过敏相关的二胺氧化酶（DAO）在中暑（HS）患者中的作用。
本研究纳入了10名重症监护病房的中暑患者和10名健康志愿者。自入院时起测量血浆肠道通透性标志物iFABP和DAO。还评估了全血内毒素。分析了iFABP、DAO与内毒素水平之间的关联。然后，检测白细胞计数、降钙素原和C反应蛋白。此外，我们还测定了促炎细胞因子如IL-1α、IL-6和TNF-α的水平。
与健康对照组相比，中暑患者血浆iFABP和DAO水平显著升高（P <.05）。动力学曲线显示，血浆iFABP和DAO水平分别在入院后第3天和第4天达到峰值。内毒素水平与iFABP和DAO水平呈正相关。我们还观察到中暑患者降钙素原和C反应蛋白水平显著升高，但白细胞计数未升高。治疗后，iFABP和DAO水平显著下降（P <.05）。中暑患者IL-1α和IL-6水平也显著升高。
DAO和iFABP的血浆浓度可以更好地反映中暑患者肠道黏膜屏障的功能。治疗后血浆iFABP和DAO水平显著下降，因此可能是中暑严重程度的一个预测指标。
