Li Zhaohui, Sheng Lei
Department of Pediatrics, Jining First People's Hospital, Jining, Shangdong 272000, P.R. China.
Exp Ther Med. 2018 Feb;15(2):1289-1292. doi: 10.3892/etm.2017.5532. Epub 2017 Nov 21.
To study the significance of dynamic evolution of serum tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) and intestinal fatty acid-binding protein (I-FABP) levels in neonatal necrotizing enterocolitis (NEC). A total of 45 NEC child patients, 45 non-NEC child patients and 45 healthy newborns were enrolled. After the day age, weight, gestational week and delivery mode were matched, the serum TNF-α, IL-6 and I-FABP levels at 6, 24 and 72 h after admission were measured via ELISA method, and their correlations with prognosis were analyzed. The levels of serum TNF-α and IL-6 in NEC and non-NEC group reached the peak at 24 h and fell at 72 h; there were no differences in each time point between the two groups (P>0.05), but the levels of serum TNF-α and IL-6 were higher than those in the control group (P<0.05). The level of serum I-FABP in NEC and non-NEC group reached the peak at 6 h, and it fell at 72 h in NEC group and 24 h in non-NEC group; the level of I-FABP in each time point in NEC was significantly higher than that in non-NEC group, and the level was the lowest in healthy group; the differences were statistically significant (P<0.05). There were 40 cases of survival and 5 cases of death (11.1%) in NEC group, while there were 43 cases of survival and 2 cases of death (4.4%) in non-NEC group. There were no differences in serum TNF-α and IL-6 levels at different times between surviving child patients and dead child patients in NEC group (P>0.05), but the levels of serum I-FABP in surviving child patients at 6 h and 24 h were significantly lower than those in dead child patients (P<0.05), and there was no difference at 72 h (P>0.05). There were no differences in serum TNF-α, IL-6 and I-FABP levels at different times between surviving and dead child patients in non-NEC group (P>0.05). Serum I-FABP level and its dynamic evolution may be important indexes of early diagnosis and prognosis evaluation of NEC.
研究血清肿瘤坏死因子-α（TNF-α）、白细胞介素6（IL-6）和肠脂肪酸结合蛋白（I-FABP）水平动态变化在新生儿坏死性小肠结肠炎（NEC）中的意义。共纳入45例NEC患儿、45例非NEC患儿及45例健康新生儿。在日龄、体重、孕周及分娩方式匹配后，采用ELISA法检测入院后6、24及72 h血清TNF-α、IL-6和I-FABP水平，并分析其与预后的相关性。NEC组和非NEC组血清TNF-α和IL-6水平在24 h达峰值，72 h下降；两组各时间点比较差异无统计学意义（P>0.05），但均高于对照组（P<0.05）。NEC组和非NEC组血清I-FABP水平在6 h达峰值，NEC组72 h下降，非NEC组24 h下降；NEC组各时间点I-FABP水平均显著高于非NEC组，健康组最低；差异有统计学意义（P<0.05）。NEC组存活40例，死亡5例（11.1%），非NEC组存活43例，死亡2例（4.4%）。NEC组存活患儿与死亡患儿不同时间血清TNF-α和IL-6水平比较差异无统计学意义（P>0.05），但存活患儿6 h和24 h血清I-FABP水平显著低于死亡患儿（P<0.05），72 h差异无统计学意义（P>0.05）。非NEC组存活患儿与死亡患儿不同时间血清TNF-α、IL-6和I-FABP水平比较差异无统计学意义（P>0.05）。血清I-FABP水平及其动态变化可能是NEC早期诊断及预后评估的重要指标。
