[血红蛋白降低对晚发型败血症早产儿坏死性小肠结肠炎的预测价值]
[Predictive value of hemoglobin decrease for necrotizing enterocolitis in preterm infants with late-onset sepsis].
作者信息
Cai Na, Shen Lei-Lei, Chen Sheng
机构信息
Department of Pediatrics, First Hospital Affiliated to Army Medical University, Chongqing 400038, China (Chen S, Email: chensheng0123456@sina. com).
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2024 Feb 15;26(2):145-150. doi: 10.7499/j.issn.1008-8830.2307011.
OBJECTIVES
To study the predictive value of hemoglobin (Hb) decrease for the occurrence of necrotizing enterocolitis (NEC) in preterm infants with late-onset sepsis (LOS) .
METHODS
Clinical data of 93 LOS preterm infants were collected for retrospective analysis, among which 16 infants developed NEC while 77 infants did not. Based on the decrease in Hb levels from the most recent Hb measurement before LOS occurrence to the initial Hb levels during LOS, the infants were divided into three groups: no Hb decrease (=15), mild Hb decrease (Hb decrease <15 g/L; =35), and severe Hb decrease (Hb decrease ≥15 g/L; =43). Multivariate logistic regression analysis was conducted to explore the predictive factors for NEC secondary to LOS, and the value of Hb decrease in predicting NEC secondary to LOS was evaluated through receiver operating characteristic curve analysis.
RESULTS
The incidence of NEC in the severe Hb decrease group, mild Hb decrease group, and no Hb decrease group were 26%, 14%, and 0% (<0.05), respectively. Multivariate logistic regression analysis revealed that a larger Hb decrease was an independent predictive factor for NEC in LOS preterm infants (=1.141, 95%: 1.061-1.277, <0.001). Receiver operating characteristic curve analysis showed that the area under the curve for predicting NEC in preterm infants with LOS using Hb decrease (with a cut-off value of 20 g/L) was 0.803, with sensitivity and specificity of 0.69 and 0.78, respectively.
CONCLUSIONS
Hb decrease can serve as an indicator for prediction of NEC in preterm infants with LOS.
目的
研究血红蛋白（Hb）下降对晚发型败血症（LOS）早产儿坏死性小肠结肠炎（NEC）发生的预测价值。
方法
收集93例LOS早产儿的临床资料进行回顾性分析，其中16例发生NEC，77例未发生。根据从LOS发生前最近一次Hb测量值到LOS期间初始Hb水平的Hb水平下降情况，将婴儿分为三组：无Hb下降（=15）、轻度Hb下降（Hb下降<15 g/L；=35）和重度Hb下降（Hb下降≥15 g/L；=43）。进行多因素logistic回归分析以探讨LOS继发NEC的预测因素，并通过受试者工作特征曲线分析评估Hb下降对LOS继发NEC的预测价值。
结果
重度Hb下降组、轻度Hb下降组和无Hb下降组的NEC发生率分别为26%、14%和0%（<0.05）。多因素logistic回归分析显示，较大的Hb下降是LOS早产儿NEC的独立预测因素（=1.141，95%：1.061-1.277，<0.001）。受试者工作特征曲线分析表明，使用Hb下降（临界值为20 g/L）预测LOS早产儿NEC的曲线下面积为0.803，敏感性和特异性分别为0.69和0.78。
结论
Hb下降可作为LOS早产儿NEC的预测指标。
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