Schat Trijntje E, Heida Fardou H, Schurink Maarten, van der Laan Michelle E, Hulzebos Christian V, Bos Arend F, Kooi Elisabeth M W, Hulscher Jan B F
Division of Neonatology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.
Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Arch Dis Child Fetal Neonatal Ed. 2016 Nov;101(6):F533-F539. doi: 10.1136/archdischild-2015-309838. Epub 2016 Apr 5.
The underlying pathophysiology of necrotising enterocolitis (NEC) remains incompletely understood, particularly the role of intestinal perfusion. We aimed to determine the relation between cerebral and splanchnic fractional tissue oxygen extraction (FTOE), a marker for tissue underperfusion, with intestinal fatty acid-binding protein in plasma (I-FABPp), a marker for intestinal damage, in infants with NEC. Furthermore, we investigated the combined courses of cerebral and splanchnic FTOE values and I-FABPp levels in uncomplicated (conservative treatment) and complicated NEC (surgery or death).
This study was part of a prospective observational cohort study.
We included 19 preterm infants with NEC (9 uncomplicated, 10 complicated).
Using near-infrared spectroscopy, we measured regional cerebral and splanchnic tissue oxygen saturations continuously for 48 h after NEC onset. We measured I-FABPp levels simultaneously.
We used Spearman correlation tests to calculate correlation coefficients between FTOE values and I-FABPp levels in uncomplicated and complicated NEC.
Median (range) gestational age was 28 (25-36) weeks and median (range) birth weight was 1290 (740-2400) g. Cerebral and splanchnic FTOE values correlated strongly with I-FABPp levels (rho between .745 and 0.900; p<0.001-0.037) during the first 16 h after NEC onset. Thereafter, in uncomplicated NEC, splanchnic FTOE values increased while I-FABPp levels decreased concomitantly. In complicated NEC both splanchnic FTOE values and I-FABPp levels decreased.
Combining cerebral and splanchnic FTOE values with I-FABPp levels, gives insight in the pathological chain of events resulting in progression or recovery of intestinal ischaemia in NEC.
NTR3239.
坏死性小肠结肠炎（NEC）的潜在病理生理学仍未完全明了，尤其是肠道灌注的作用。我们旨在确定患有NEC的婴儿中，脑和内脏组织氧提取分数（FTOE，组织灌注不足的一个指标）与血浆中肠脂肪酸结合蛋白（I-FABPp，肠道损伤的一个指标）之间的关系。此外，我们研究了在非复杂性（保守治疗）和复杂性NEC（手术或死亡）中脑和内脏FTOE值及I-FABPp水平的联合变化过程。
本研究是一项前瞻性观察队列研究的一部分。
我们纳入了19例患有NEC的早产儿（9例非复杂性，10例复杂性）。
在NEC发病后48小时内，我们使用近红外光谱法连续测量局部脑和内脏组织氧饱和度。同时测量I-FABPp水平。
我们使用Spearman相关检验计算非复杂性和复杂性NEC中FTOE值与I-FABPp水平之间的相关系数。
胎龄中位数（范围）为28（25 - 36）周，出生体重中位数（范围）为1290（740 - 2400）g。在NEC发病后的最初16小时内，脑和内脏FTOE值与I-FABPp水平密切相关（rho在0.745至0.900之间；p<0.001 - 0.037）。此后，在非复杂性NEC中，内脏FTOE值升高，而I-FABPp水平随之下降。在复杂性NEC中，内脏FTOE值和I-FABPp水平均下降。
将脑和内脏FTOE值与I-FABPp水平相结合，有助于深入了解导致NEC肠道缺血进展或恢复的病理事件链。
NTR3239。
