Values of histidinedecarboxylase,intestinal fatty acid binding protein,and diamine oxidase for diagnosingintestinal mucosal injury in patients with intestinal obstruction

Abstract

：Objective To investigatethe clinical values of serum histidine decarboxylase(HDC),intestinal fatty acid bindingprotein(I-FABP),and diamine oxidase(DAO)for diagnosing intestinal mucosal injury (IMI)inpatients with intestinal obstruction.Methods The expression levels of serum HDC,I-FABP,andDAO in 28 patients with strangulated intestinal obstruction,19 patients with simpleintestinal obstruction,17 patients with acute simple appendicitis,and 20 healthy controlwere determined by enzyme-linked immunosorbent assay (ELISA)before clinical treatment,andthen the areaa under receiver operating characteristic curves(AUC)of these diagnosticindicators were compared.In addition,the incidences of systemic inflammatory responsesyndrome (SIRS)and infectious complications were closely observed.The difference of theexpressions of HDC,I-FABP,and DAO and their relationship with SIRS and infectiouscomplications were compared among these patients and controls.Results The expressionlevels of serum HDC, I-FABP, and DAO were the highest in patients with strangulatedintestinal obstruction (all P < 0.001), and the expression levels of these threeindicators were significantly higher in patients with simple intestinal obstruction thanin those with acute simple appendicitis or healthy controls (all P<0.05).The AUC of HDC(0.913) was significantly larger than that of I-FABP (0.877, P =0.000) and DAO (0.873, P =0.000).When the cut-off value of HDC ≥31.00 ng/ml, the sensitivity, specificity, false negative rate, andfalse positive rate of HDC were 74.5% , 94.6% , 25.5% , and 5.4% , respectively,which wereall better than those of I-FABP and DAO.There were significant differences of theincidence of SIRS ( P = 0.046) and abdominal infection (P = 0.027) among patients withstrangulated intestinal obstruction, patients with simple intestinal obstruction, andpatients with acute simple appendicitis, while lung infection showed no such significantdifference (P = 0.728).The expression level of serum HDC was significantly higher inpatients with strangulated intestinal obstruction who were also suffered from SIRS ( P =0.000) or abdominal infection ( P =0.002) than that of uninfected patients.Meanwhile, theexpression levels of serum I-FABP and DAO were significantly higher in the SIRS patientswith strangulated intestinal obstruction than that of uninfected patients ( P = 0.027,P=0.017, respectively).The expression levels of HDC, I-FABP, and DAO were significantlycorrelated with the incideces of SIRS and abdominal infection ( all P < 0.05 ) , amongwhich the level of HDC and the incidence of SIRS had the highest correlation (R = 0.608, P= 0.001).Conclusion HDC can be an effective indicator for diagnosing IMI in patients withintestinal obstruction. Key words: Histidine decarboxylase; Intestinal fatty acid binding protein; Diamine oxidase; Intestinal obstruction; Intestinal mucosal injury