[肠道局部氧饱和度及C反应蛋白在早产儿坏死性小肠结肠炎诊断中的价值]
[Value of intestinal regional oxygen saturation and C-reactive protein in the diagnosis of necrotizing enterocolitis in preterm infants].
作者信息
Jie Shuang-Shuang, Dai Li-Ying, Zhang Jian, Zhang Yong-Li, Zhang Feng
机构信息
Department of Neonatology, Anhui Children's Hospital, Anhui Medical University/Fifth Clinical Medical College of Anhui Medical University, Hefei 230000, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Nov 15;24(11):1202-1206. doi: 10.7499/j.issn.1008-8830.2204047.
OBJECTIVES
To study the clinical value of intestinal regional oxygen saturation (rSO) and C-reactive protein (CRP) in the diagnosis of necrotizing enterocolitis (NEC) in preterm infants.
METHODS
A prospective observational study was conducted among the preterm infants who were hospitalized in Children's Hospital Affiliated to Anhui Medical University, from October 2020 to December 2021, with 22 infants in the NEC group and 35 infants in the non-NEC group. Intestinal rSO was monitored 24 hours after a confirmed diagnosis of NEC in the NEC group, and serum CRP levels were measured before anti-infection therapy. In the non-NEC group, intestinal rSO monitoring and serum CRP level measurement were performed at the corrospording time points. The two groups were compared in terms of intestinal rSO and serum CRP level. The receiver operating characteristic (ROC) curve was used to analyze the value of intestinal rSO alone, serum CRP alone, and intestinal rSO combined with CRP in the diagnosis of NEC in preterm infants.
RESULTS
Compared with the non-NEC group, the NEC group had a significantly lower level of intestinal rSO (<0.05) and a higher serum CRP level (<0.05). The ROC curve analysis showed that intestinal rSO had an optimal cut-off value of 50.75% in the diagnosis of NEC in preterm infants, with a sensitivity of 81.8%, a specificity of 85.7%, and an area under the ROC curve (AUC) of 89.4%; CRP had an optimal cut-off value of 12.05 mg/L in the diagnosis of NEC in preterm infant, with a sensitivity of 72.7%, a specificity of 74.3%, and an AUC of 74.8%; intestinal rSO combined with CRP had a sensitivity of 90.9%, a specificity of 77.1%, and an AUC of 91.9% in the diagnosis of NEC. The AUC of intestinal rSO alone in the diagnosis NEC was higher than that of CRP (<0.05). There was no significant difference in the AUC between intestinal rSO alone and intestinal rSO combined with CRP (>0.05).
CONCLUSIONS
The value of intestinal rSO in the diagnosis NEC is higher than that of CRP, and is equivalent to that of the combination of intestinal rSO and CRP in preterm infants.
目的
探讨肠道局部氧饱和度（rSO）及C反应蛋白（CRP）在早产儿坏死性小肠结肠炎（NEC）诊断中的临床价值。
方法
对2020年10月至2021年12月在安徽医科大学附属儿童医院住院的早产儿进行前瞻性观察研究，NEC组22例，非NEC组35例。NEC组确诊NEC后24小时监测肠道rSO，在抗感染治疗前检测血清CRP水平。非NEC组在相应时间点进行肠道rSO监测及血清CRP水平检测。比较两组肠道rSO及血清CRP水平。采用受试者工作特征（ROC）曲线分析肠道rSO、血清CRP单独及二者联合对早产儿NEC的诊断价值。
结果
与非NEC组比较，NEC组肠道rSO水平显著降低（<0.05），血清CRP水平升高（<0.05）。ROC曲线分析显示，肠道rSO诊断早产儿NEC的最佳截断值为50.75%，灵敏度为81.8%，特异度为85.7%，ROC曲线下面积（AUC）为89.4%；CRP诊断早产儿NEC的最佳截断值为12.05 mg/L，灵敏度为72.7%，特异度为74.3%，AUC为74.8%；肠道rSO联合CRP诊断NEC的灵敏度为90.9%，特异度为77.1%，AUC为91.9%。肠道rSO单独诊断NEC的AUC高于CRP（<0.05）。肠道rSO单独与肠道rSO联合CRP的AUC比较差异无统计学意义（>0.
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