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早产儿坏死性小肠结肠炎严重程度的生物标志物:一项初步研究。

Biomarkers in the Severity of Necrotizing Enterocolitis in Preterm Infants: A Pilot Study.

作者信息

Meng Wei, Wang Qing, Xu Qingyu, Gao Hongli, Zhou Yunjun, Shao Wei

机构信息

Department of Pediatric Internal Medicine, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang, People's Republic of China.

Department of Pediatrics Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang, People's Republic China.

出版信息

Int J Gen Med. 2024 Mar 15;17:1017-1023. doi: 10.2147/IJGM.S446378. eCollection 2024.

Abstract

BACKGROUND

The occurrence of necrotizing enterocolitis (NEC) is a common and severe disease of the digestive system in neonates. This study aims to assess the value of the intestinal tissue oxygen saturation (rSO) combined with the levels of procalcitonin (PCT) and mean platelet volume (MPV) in predicting the severity of NEC in preterm infants.

METHODS

This experiment was a retrospective cohort study conducted in the Department of Pediatrics, Hongqi Hospital Affiliated to Mudanjiang Medical University between January 2017 and July 2022. Premature neonates with NEC were enrolled and divided into mild-moderate NEC group and severe NEC group according to Bell's stage. The general information data, rSO and blood parameters such as the white blood cell (WBC) count, platelet count (PLT), PCT, MPV, red blood cell distribution width (RDW), hemoglobin (Hb), C-reactive protein (CRP) were compared between the two groups.

RESULTS

A total of 122 patients were enrolled, including 79 mild-moderate NEC and 43 severe NEC. The rSO was lower in severe group than in mild-moderate group ( = 0.042), the PCT and MPV were both higher in severe group than in mild-moderate group ( = 0.048, = 0.049). The results of logistic regression suggested that the rSO (OR = 1.491, 0.003), PCT (OR = 3.071, 0.001) and MPV (OR = 4.027, 0.015) were independent predictive factors for severity of NEC. The area under the curve (AUC) of the rSO combined with PCT and MPV showed good diagnostic ability in the severity of NEC.

CONCLUSION

The rSO combined with PCT and MPV may be considered as the early biomarkers in the severity of NEC and could help us to diagnose the case early with early treatment with better prognosis.

摘要

背景

坏死性小肠结肠炎(NEC)的发生是新生儿消化系统常见且严重的疾病。本研究旨在评估肠道组织氧饱和度(rSO)联合降钙素原(PCT)水平及平均血小板体积(MPV)在预测早产儿NEC严重程度方面的价值。

方法

本实验为回顾性队列研究,于2017年1月至2022年7月在牡丹江医学院附属红旗医院儿科进行。纳入患有NEC的早产儿,并根据贝尔分期分为轻度 - 中度NEC组和重度NEC组。比较两组的一般信息数据、rSO以及血液参数,如白细胞(WBC)计数、血小板计数(PLT)、PCT、MPV、红细胞分布宽度(RDW)、血红蛋白(Hb)、C反应蛋白(CRP)。

结果

共纳入122例患者,其中轻度 - 中度NEC 79例,重度NEC 43例。重度组的rSO低于轻度 - 中度组( = 0.042),重度组的PCT和MPV均高于轻度 - 中度组( = 0.048, = 0.049)。逻辑回归结果表明,rSO(OR = 1.491, 0.003)、PCT(OR = 3.071, 0.001)和MPV(OR = 4.027, 0.015)是NEC严重程度的独立预测因素。rSO联合PCT和MPV的曲线下面积(AUC)在NEC严重程度方面显示出良好的诊断能力。

结论

rSO联合PCT和MPV可被视为NEC严重程度的早期生物标志物,有助于早期诊断病例并进行早期治疗,从而获得更好的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7407/10950000/a7df467c9a54/IJGM-17-1017-g0001.jpg

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