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血清淀粉样蛋白A、降钙素原及高迁移率族蛋白B1水平在新生儿坏死性小肠结肠炎诊断中的意义

Diagnostic significance of serum levels of serum amyloid A, procalcitonin, and high-mobility group box 1 in identifying necrotising enterocolitis in newborns.

作者信息

Guo Li-Ming, Jiang Zhi-Hui, Liu Hong-Zhen, Zhang Lei

机构信息

Department of General Surgery, Qingdao Women and Children's Hospital, Qingdao 266000, Shandong Province, China.

Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong University, Jinan 250022, Shandong Province, China.

出版信息

World J Gastrointest Surg. 2024 Jul 27;16(7):2003-2011. doi: 10.4240/wjgs.v16.i7.2003.

Abstract

BACKGROUND

Necrotising enterocolitis (NEC) is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates. Serum amyloid A (SAA), procalcitonin (PCT), and high-mobility group box 1 (HMGB1) have emerged as potential biomarkers for NEC due to their roles in inflammatory response, tissue damage, and immune regulation.

AIM

To evaluate the diagnostic value of SAA, PCT, and HMGB1 in the context of NEC in newborns.

METHODS

The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital. Clinical, radiological, and laboratory findings, including serum SAA, PCT, and HMGB1 Levels, were collected, and specific detection methods were used. The diagnostic value of the biomarkers was evaluated through statistical analysis, which was performed using chi-square test, -test, correlation analysis, and receiver operating characteristic (ROC) analysis.

RESULTS

The study demonstrated significantly elevated levels of serum SAA, PCT, and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls. The correlation analysis indicated strong positive correlations among serum SAA, PCT, and HMGB1 Levels and the presence of NEC. ROC analysis revealed promising sensitivity and specificity for serum SAA, PCT, and HMGB1 Levels as potential diagnostic markers. The combined model of the three biomarkers demonstrating an extremely high area under the curve (0.908).

CONCLUSION

The diagnostic value of serum SAA, PCT, and HMGB1 Levels in NEC was highlighted. These biomarkers potentially improve the early detection, risk stratification, and clinical management of critical conditions. The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.

摘要

背景

坏死性小肠结肠炎(NEC)是一种危及生命的胃肠道急症,影响早产和低体重新生儿。血清淀粉样蛋白A(SAA)、降钙素原(PCT)和高迁移率族蛋白B1(HMGB1)因其在炎症反应、组织损伤和免疫调节中的作用,已成为NEC的潜在生物标志物。

目的

评估SAA、PCT和HMGB1在新生儿NEC中的诊断价值。

方法

本研究回顾性分析了48例诊断为NEC的新生儿和50例入院的健康新生儿的临床资料。收集了临床、放射学和实验室检查结果,包括血清SAA、PCT和HMGB1水平,并采用特定的检测方法。通过统计学分析评估生物标志物的诊断价值,采用卡方检验、t检验、相关性分析和受试者操作特征(ROC)分析。

结果

研究表明,与健康对照组相比,诊断为NEC的新生儿血清SAA、PCT和HMGB1水平显著升高。相关性分析表明,血清SAA、PCT和HMGB1水平与NEC的存在呈强正相关。ROC分析显示,血清SAA、PCT和HMGB1水平作为潜在诊断标志物具有良好的敏感性和特异性。三种生物标志物的联合模型显示曲线下面积极高(0.908)。

结论

强调了血清SAA、PCT和HMGB1水平在NEC中的诊断价值。这些生物标志物可能改善危急情况的早期检测、风险分层和临床管理。研究结果表明,这些生物标志物可能有助于及时干预并改善受NEC影响新生儿的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd9e/11287675/4f99a6237f5f/WJGS-16-2003-g001.jpg

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