粪便胆汁盐与早产儿坏死性小肠结肠炎的发生
Fecal Bile Salts and the Development of Necrotizing Enterocolitis in Preterm Infants.
作者信息
Hulzebos Christian V, van Zoonen Anne G J F, Hulscher Jan B F, Schat Trijntje E, Kooi Elisabeth M W, Koehorst Martijn, Boverhof Renze, Krabbe Paul F M, Groen Albert K, Verkade Henkjan J
机构信息
Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
出版信息
PLoS One. 2017 Jan 3;12(1):e0168633. doi: 10.1371/journal.pone.0168633. eCollection 2017.
BACKGROUND
Intestinal bile salts (BSs) may be implicated in NEC development. We hypothesized that fecal BS levels are higher in preterm infants at risk for NEC.
METHODS
We compared the composition and concentration of fecal BSs in ten preterm infants who developed NEC (Bell's Stage ≥ II) with twenty matched control infants without NEC. Conjugated and unconjugated fecal BSs were measured after birth (T1) and twice prior to NEC (T2, T3). Data are presented as medians and interquartile ranges.
RESULTS
GA and BW were similar in all preterms: ~27+4 weeks and ~1010 g. Age of NEC onset was day 10 (8-24). T1 was collected 2 (1-3) days after birth. T2 and T3 were collected 5 (5-6) days and 1 (0-2) day before NEC or at corresponding postnatal ages in controls. The composition of conjugated BSs did not differ between the two groups. Total unconjugated BSs were 3-fold higher before NEC compared to controls at corresponding ages (0.41 μmol/g feces (0.21-0.74) versus 0.14 μmol/g feces (0.06-0.46), p < 0.05).
CONCLUSION
Fecal BS concentrations are higher in preterm infants who develop NEC compared to infants without NEC. Further study is needed to determine the predictive value of fecal BSs in the development of NEC.
背景
肠道胆汁盐（BSs）可能与坏死性小肠结肠炎（NEC）的发生有关。我们假设，有NEC风险的早产儿粪便中BS水平更高。
方法
我们比较了10例发生NEC（Bell分期≥Ⅱ期）的早产儿与20例匹配的未发生NEC的对照早产儿粪便中BS的成分和浓度。在出生后（T1）以及NEC发生前两次（T2、T3）测量结合型和非结合型粪便BS。数据以中位数和四分位数间距表示。
结果
所有早产儿的胎龄（GA）和出生体重（BW）相似：约27 + 4周和约1010克。NEC发病年龄为第10天（8 - 24天）。T1在出生后2（1 - 3）天采集。T2和T3在NEC发生前5（5 - 6）天和1（0 - 2）天采集，或在对照组相应的出生后年龄采集。两组结合型BS的成分无差异。与相应年龄的对照组相比，NEC发生前总非结合型BS高出3倍（0.41 μmol/g粪便（0.21 - 0.74）对0.14 μmol/g粪便（0.06 - 0.46），p < 0.05）。
结论
与未发生NEC的婴儿相比，发生NEC的早产儿粪便中BS浓度更高。需要进一步研究以确定粪便BS在NEC发生中的预测价值。
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