肿瘤坏死因子-α、白细胞介素-6及肠道脂肪酸结合蛋白水平动态变化在新生儿坏死性小肠结肠炎中的意义
Significance of dynamic evolution of TNF-α, IL-6 and intestinal fatty acid-binding protein levels in neonatal necrotizing enterocolitis.
作者信息
Li Zhaohui, Sheng Lei
机构信息
Department of Pediatrics, Jining First People's Hospital, Jining, Shangdong 272000, P.R. China.
出版信息
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。
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