观察缺血性肠病（ICBD）患者D-二聚体（D-D）、肠道脂肪酸结合蛋白（I-FABP）变化及CT血管成像（CTA）的特征。

回顾性分析南京市高淳人民医院2022年3月至2024年3月收治的204例疑似缺血性肠病患者的临床资料，根据病理结果将确诊ICBD患者纳入ICBD组，其余为非ICBD组。收集所有受试者的CTA特征、D-D、I-FABP水平，比较两组上述指标差异，使用受试者工作特征（ROC）曲线，分析CTA特征、D-D、I-FABP诊断缺血性肠病的效能及曲线下面积（AUC）。

本研究纳入的204例疑似ICBD患者中，病理确诊104例，CTA检查征象可见：累及小肠60例（57.69%）、结肠34例（32.69%），大小肠均受累10例（9.62%）。其中肠壁增厚88例（84.62%），肠壁积气16例（15.38%），肠管扩张52例（50.00%），肠壁强化减弱78例（75.00%），腹腔积液30例（28.85%），肠系膜水肿6例（5.77%），肠梗阻8例（7.69%）。采用Fisher确切概率法比较两组影像学特征的阳性率差异有统计学意义（P<0.05）。ICBD组D-D、I-FABP水平高于非ICBD组（P<0.05），ROC曲线显示，I-FABP、D-D、CTA影像评分的AUC分别为0.808、0.783、0.776，I-FABP对ICBD的诊断效能显著优于D-D及影像评分，D-D对ICBD诊断效能略高于影像评分，三者联合的AUC为0.905，德隆检验显示，联合模型的AUC显著高于I-FABP（Z=3.87，P<0.001）、D-D（Z=4.52，P<0.001）及CTA影像评分（Z=4.91，P<0.001），而单一指标间差异均无统计学意义（P>0.0083）。

ICBD患者的D-D、I-FABP变化及CTA特征联合模型，可提高早期诊断的准确性，为ICBD的病情评估和治疗方案制定提供了新的依据。

To explore the changes of D-dimer (D-D), intestinal fatty acid-binding protein (I-FABP) and the characteristics of CT angiography (CTA) in patients with ischemic bowel disease (ICBD).

A retrospective analysis was conducted on the clinical data of 204 patients with suspected ICBD admitted to Nanjing Gaochun People's Hospital from March 2022 to March 2024. According to the pathological results, patients diagnosed with ICBD were included in the ICBD group, and those diagnosed with non-ICBD were included in the non-ICBD group. The CTA characteristics, D-D and I-FABP levels of all subjects were collected, the differences in the above indicators between the two groups were compared. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of CTA characteristics, D-D and I-FABP in diagnosing ICBD and the area under the curve (AUC).

Among the 204 suspected ICBD patients included in this study, 104 cases were pathologically diagnosed, and the CTA examination signs showed that 60 cases (57.69%) involved the small intestine, 34 cases (32.69%) involved the colon, and 10 cases (9.62%) involved both the large and small intestines. Among them, there were 88 cases (84.62%) of intestinal wall thickening, 16 cases (15.38%) of intestinal wall gas accumulation, 52 cases (50.00%) of intestinal dilation, 78 cases (75.00%) of weakened intestinal wall enhancement, 30 cases (28.85%) of peritoneal effusion, 6 cases (5.77%) of mesenteric edema, and 8 cases (7.69%) of intestinal obstruction. The difference in the positive rate of imaging features between the two groups by Fisher's exact probability method was statistically significant (P<0.05). The levels of D-D and I-FABP in the ICBD group were higher than those in the non-ICBD group (P<0.05). The ROC curve showed that the AUC for I-FABP, D-D, and CTA imaging scores were 0.808, 0.783 and 0.776. The diagnostic efficacy of I-FABP for ICBD was significantly better than that of D-D and the image score, the diagnostic efficacy of D-D for ICBD was slightly higher than that of the image score, and the AUC of the three combined was 0.905. The Delon test showed that the AUC of the combined model was significantly higher than that of I-FABP (Z=3.87, P<0.001), D-D (Z=4.52, P<0.001), and CTA image score (Z=4.91, P<0.001), while there was no statistically significant difference among the single indicators (all P>0.0083).

The combined model of D-D, I-FABP changes and CTA characteristics in patients with ICBD improves the accuracy of early diagnosis and provides new basis for condition assessment and treatment plan formulation of ICBD.