[Diagnostics of intestinal ischemia. Influence of surgery on plasma levels of I-FABP as the marker of enterocyte injury].
BACKGROUND
Intestinal fatty acid binding protein (I-FABP) deriving from the cytoplasm of the intestinal epithelial cells is a new biochemical marker with potential to indicate intestinal mucosal injury early in the phase of enterocyte damage. I-FABP is thought to be promising marker for detection of the systemic inflammatory response syndrome (SIRS) and sepsis before its onset.


OBJECTIVE
The aim of the study was to consider the influence of surgery on I-FABP plasma levels.


METHODS
Fifty-six consecutive patients undergoing elective surgery were prospectively studied. Only patients with major surgical procedure were involved in the study. Patients were divided into three groups: group A (n=19) patients with open abdominal surgery, group B (n=19) patients with laparoscopic abdominal surgery and group C (n=15) patients with thoracic surgery. From every patient in the study six samples of venous blood were taken in these intervals: preoperatively, immediately postoperatively and 4, 12, 24 and 48 hours after the surgery. Plasma samples were analysed for I-FABP levels by enzyme linked immunosorbent assay.


RESULTS
There were no differences in the mean plasma I-FABP levels within the groups (ANOVA, p > 0.05), except significant decrease of the I-FABP level 48 hours after the surgery in contrast to preoperative plasma concentration in group B (82.60 pg/ml vs. 229.00 pg/ml; p = 0.025) and group C (88.99 pg/ml vs. 194.96 pg/ml; p = 0.0347). There were no differences in the mean I-FABP plasma concentrations among the groups preoperatively, immediately postoperatively and 4, 12. 24 and 48 hours after the surgery (ANOVA, p > 0.05). No differences were found in the I-FABP plasma levels related to preoperative laxative drug use, duration of surgery, small bowel resection and SIRS in postoperative period (t-test, p > 0.05).


CONCLUSIONS
There were no differences in the mean plasma I-FABP levels preoperatively and in the postoperative period after the major surgery. Because surgery alone probably has no influence on I-FABP plasma levels we can say that the concept of l-FABP as the early marker of the intestinal mucosal injury is also viable in postoperative period.
Mitták
M
M
Chirurgická klinika Fakultní nemocnice Ostrava. marcel.mittak@fnspo.cz
Karlík
T
T
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D020895:Enterocytes / Q000473:pathology; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply* / Q000473:pathology; D007511:Ischemia / Q000097:blood / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins