Division of Neonatology, Department of Pediatrics, Maimonides Medical Center, Brooklyn, New York.
George Washington University Hospital, Children's National Health System, Washington, DC.
Am J Perinatol. 2021 Nov;38(13):1435-1441. doi: 10.1055/s-0040-1713406. Epub 2020 Jun 30.
Citrulline synthesized by healthy enterocytes and decreases with injury. This work aimed to study plasma citrulline concentrations (CITs) as a biomarker to differentiate among infants presenting with early nonspecific signs and symptoms of necrotizing enterocolitis (NEC) with those who will develop NEC. Further to study the correlation between posttreatment CIT with time to full feeds (TTFF) and length of stay (LOS).
This is a prospective study which included infants < 32 weeks gestational age (GA) with 9 infants each in Group 1 (stage 2/3 NEC), Group 2 (with stage 1 NEC-like presentation), and Group 3 (healthy GA-matched infants). CIT was measured in Groups 1 and 2 within 24 hours of presentation and again in Group 1 after treatment.
The three groups were similar in clinical characteristics. Median CIT (µmol/L) in Group 1 (15.4 [interquartile range, IQR: 7.3-18.0]) was lower than Group 2 (22.2 [IQR: 18.3-27.3], = 0.02) and Group 3 (24.9 [IQR: 19.8-31.9], = 0.009). Posttreatment CIT in Group 1 did not correlate with TTFF ( = 0.15; = 0.69) and LOS ( = - 0.33; = 0.38).
CIT was lower in infants with NEC as compared with healthy controls and those infants with nonspecific signs of NEC. CIT after treatment does not correlate with TTFF and LOS.
· Citrulline is produced by enterocytes.. · It is decreased in infants with necrotizing enterocolitis early in disease.. · It can be used as a biomarker for early diagnosis of necrotizing enterocolitis..
健康的肠细胞合成瓜氨酸，而瓜氨酸在损伤时会减少。本研究旨在研究血浆瓜氨酸浓度（CIT）作为一种生物标志物，以区分出现早期非特异性症状和体征的坏死性小肠结肠炎（NEC）患儿与将要发生 NEC 的患儿。进一步研究治疗后 CIT 与完全喂养时间（TTFF）和住院时间（LOS）之间的相关性。
这是一项前瞻性研究，纳入了 <32 周胎龄（GA）的婴儿，每组 9 例，分别为 1 组（2/3 期 NEC）、2 组（表现为 1 期 NEC 样表现）和 3 组（GA 匹配的健康婴儿）。在出现症状后 24 小时内测量 1 组和 2 组的 CIT，然后在 1 组治疗后再次测量。
三组患儿的临床特征相似。1 组的中位 CIT（µmol/L）为 15.4（四分位距[IQR]：7.3-18.0），低于 2 组（22.2 [IQR：18.3-27.3]，=0.02）和 3 组（24.9 [IQR：19.8-31.9]，=0.009）。1 组治疗后的 CIT 与 TTFF 无相关性（=0.15；=0.69）和 LOS 无相关性（=0.33；=0.38）。
与健康对照组和非特异性 NEC 症状的婴儿相比，NEC 婴儿的 CIT 较低。治疗后的 CIT 与 TTFF 和 LOS 无关。
·瓜氨酸由肠细胞产生。·在疾病早期，坏死性小肠结肠炎患儿的瓜氨酸减少。·它可作为早期诊断坏死性小肠结肠炎的生物标志物。
