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坏死性小肠结肠炎发病时血清白蛋白是否可预测早产儿的严重疾病?

Does serum albumin at the onset of necrotisıng enterocolitis predict severe disease in preterm infants?

机构信息

Department of Neonatology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey.

Department of Pediatric Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey.

出版信息

Pediatr Surg Int. 2024 Oct 9;40(1):267. doi: 10.1007/s00383-024-05850-6.

DOI:10.1007/s00383-024-05850-6
PMID:39382780
Abstract

OBJECTIVE

To investigate whether laboratory markers obtained at the onset of necrotising enterocolitis (NEC) predict the severity of the disease in preterm infants.

METHODS

Prospective cohort study conducted in a tertiary referance hospital. A total of 88 preterm infants were included in the study. Of those, 60 infants had the diagnosis of severe NEC, while the remaining 28 infants constituted the non-severe NEC group. Severe NEC was defined as surgical NEC or NEC-related mortality. Infants with and without severe NEC were compared in terms of demographic, clinical and laboratory characteristics.

RESULTS

At the onset of disease, infants with severe NEC noted to have lower platelet count and serum ALB levels (p = 0.011, p = 0.004; respectively), whereas higher CRP, and serum lactate levels (p = 0.009, p = 0.008; respectively). Multiple binary logistic regression analyses showed that CRP (1.03(1.01-1.05), p = 0.024) and serum albumin level (0.16(0.04-0.64), p = 0.010) were statistically significant independent risk factors for severe NEC. The optimal cut-off value for the serum ALB level was found to be 23 g/L with 52% sensitivity (95%CI: 37-68%) and 84% specificity (95%CI: 60-97%) (AUC 0.727; p = 0.002).

CONCLUSION

Serum ALB level at NEC onset might be a reliable biomarker for severe disease in preterm infants.

摘要

目的

研究坏死性小肠结肠炎(NEC)发病时的实验室标志物是否能预测早产儿 NEC 的严重程度。

方法

这是一项在三级转诊医院进行的前瞻性队列研究。共纳入 88 例早产儿,其中 60 例患儿被诊断为严重 NEC,其余 28 例患儿构成非严重 NEC 组。严重 NEC 定义为手术 NEC 或与 NEC 相关的死亡率。比较两组患儿在人口统计学、临床和实验室特征方面的差异。

结果

在疾病发病时,严重 NEC 患儿的血小板计数和血清 ALB 水平较低(p=0.011,p=0.004;分别),而 CRP 和血清乳酸水平较高(p=0.009,p=0.008;分别)。多因素二元逻辑回归分析显示,CRP(1.03(1.01-1.05),p=0.024)和血清白蛋白水平(0.16(0.04-0.64),p=0.010)是严重 NEC 的独立危险因素。血清 ALB 水平的最佳截断值为 23g/L,具有 52%的敏感性(95%CI:37-68%)和 84%的特异性(95%CI:60-97%)(AUC 0.727;p=0.002)。

结论

NEC 发病时的血清 ALB 水平可能是预测早产儿严重疾病的可靠生物标志物。

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