Evaluation value of acute gastrointestinal injury severity by serum intestinal fatty acid binding protein combined with D-lactate and ultrasonic score

Wei Min; Yu Zejia; Yao Hui; Feng Jun

doi:10.3760/j.issn.1673-4777.2026.06.014

Abstract：Objective To explore the value of serum intestinal fatty acid binding protein(IFABP)combined with D-lactate and ultrasonic score in evaluating the severity of acute gastrointestinal injury(AGI).Methods A prospective study was conducted on 106 patients with AGI admitted to Nanping First Hospital Affiliated to Fujian Medical University from December 2023 to December 2025.The patients were divided into mild group(grade Ⅰ and Ⅱ)and moderate-severe group(grade Ⅲ and Ⅳ)according to the injury degree.All patients underwent detection of serum IFABP and D-lactate as well as abdominal ultrasonography,with ultrasonic scores recorded.Logistic regression analysis and receiver operating characteristic(ROC)curve were used to explore the evaluation value of serum IFABP,D-lactate combined with ultrasonic score for AGI severity.Results Among 106 AGI patients,there were 45 cases(42.4％)of grade Ⅰ,37 cases(34.9％)of grade Ⅱ,22 cases(20.7％)of grade Ⅲ,and 2 cases(1.9％)of grade Ⅳ.The levels of serum IFABP and D-lactate in the moderate-severe group were higher than those in the mild group[(156±42)ng/L vs(106±37)ng/L,(9.6±3.9)mg/L vs(6.3±2.6)mg/L](all P＜0.001),and the proportion of ultrasonic score＞2 was higher than that in the mild group[70.8％(17/24)vs 35.4％(29/82)](P=0.002).The sequential organ failure assessment(SOFA)score and proportion of vasoactive drug use in the moderate-severe group were higher,while the albumin level was lower than those in the mild group(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum IFABP,D-lactate,ultrasonic score alone and their combination for evaluating AGI severity were 0.816,0.748,0.677 and 0.908 respectively.The AUC of the combined three indicators was higher than that of D-lactate and ultrasonic score(Z=2.280,P=0.011;Z=3.177,P=0.001),and there was no significant difference compared with the AUC of serum IFABP(Z=1.503,P=0.067).Multivariate Logistic analysis showed that SOFA score,albumin,vasoactive drugs,serum IFABP,D-lactate and ultrasonic score were independent influencing factors of AGI severity(P＜0.05).Conclusion Serum IFABP combined with D-lactate and ultrasonic score has high value in evaluating the severity of AGI.