Frid Gabriela, Reppucci Marina, Lum Tony, Paul Megan, Seiden Howard, Coakley Brian A
The Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Front Pediatr. 2021 Dec 20;9:802607. doi: 10.3389/fped.2021.802607. eCollection 2021.
Necrotizing enterocolitis (NEC) is a serious illness that occurs among premature infants and term-born infants with congenital heart disease (CHD). Prior studies have suggested these two groups may experience different disease entities. We sought to evaluate if there are differences in disease characteristics between these two populations. A retrospective chart review of infants treated for Bells stage 2-3 NEC from 2011 to 2020 was performed. Demographic information, CHD diagnoses and clinical data were recorded. Prior to data analysis, patients were divided into two groups: term-born patients with CHD (TC) and premature patients without CHD (PT). 99 patients were analyzed-23 TC patients and 76 PT patients. Platelet counts (222.7 ± 176.1 vs. 310.2 ± 174.5 cells/uL, = 0.03) and C-reactive protein (CRP) levels (53.6 ± 81.7 vs. 117.6 ± 90.4 mg/L, < 0.001) were significantly higher among the PT group. In addition, PT patients were more likely to develop pneumatosis (30.4 vs. 68.4%, = 0.002) than TC patients. NEC-specific mortality was similar between both groups of patients. When compared to TC patients, PT patients had higher CRP levels, higher platelet counts and more commonly developed pneumatosis. These factors may point toward a difference in disease pathophysiology regarding NEC development in premature patients vs. term-born patients with CHD.
坏死性小肠结肠炎（NEC）是一种发生在早产儿和患有先天性心脏病（CHD）的足月儿中的严重疾病。先前的研究表明，这两组患者可能经历不同的疾病实体。我们试图评估这两个人群在疾病特征上是否存在差异。对2011年至2020年接受贝尔2 - 3期NEC治疗的婴儿进行了回顾性病历审查。记录了人口统计学信息、CHD诊断和临床数据。在数据分析之前，将患者分为两组：患有CHD的足月儿（TC）和没有CHD的早产儿（PT）。共分析了99例患者，其中23例TC患者和76例PT患者。PT组的血小板计数（222.7±176.1对310.2±174.5细胞/微升，P = 0.03）和C反应蛋白（CRP）水平（53.6±81.7对117.6±90.4毫克/升，P < 0.001）显著更高。此外，PT患者比TC患者更易发生肠壁积气（30.4%对68.4%，P = 0.002）。两组患者的NEC特异性死亡率相似。与TC患者相比，PT患者的CRP水平更高、血小板计数更高且更常发生肠壁积气。这些因素可能表明早产儿与患有CHD的足月儿在NEC发生的疾病病理生理学方面存在差异。
