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从历史和人工智能角度理解坏死性小肠结肠炎的内型和获得性肠道损伤表型。

Understanding necrotizing enterocolitis endotypes and acquired intestinal injury phenotypes from a historical and artificial intelligence perspective.

作者信息

Cuna Alain, Kumar Navin, Sampath Venkatesh

机构信息

Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, United States.

School of Medicine, University of Missouri-Kansas City, Kansas City, MO, United States.

出版信息

Front Pediatr. 2024 Sep 27;12:1432808. doi: 10.3389/fped.2024.1432808. eCollection 2024.

DOI:10.3389/fped.2024.1432808
PMID:39398415
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11466774/
Abstract

Necrotizing enterocolitis (NEC) remains a devastating disease in preterm and term neonates. Despite significant progress made in understanding NEC pathogenesis over the last 50 years, the inability of current definitions to discriminate the various pathophysiological processes underlying NEC has led to an umbrella term that limits clinical and research progress. In this mini review, we provide a historical perspective on how NEC definitions and pathogenesis have evolved to our current understanding of NEC endotypes. We also discuss how artificial intelligence-based approaches are influencing our knowledge of risk-factors, classification and prognosis of NEC and other neonatal intestinal injury phenotypes.

摘要

坏死性小肠结肠炎(NEC)在早产和足月新生儿中仍然是一种毁灭性疾病。尽管在过去50年中对NEC发病机制的理解取得了重大进展,但目前的定义无法区分NEC潜在的各种病理生理过程,导致了一个概括性术语,限制了临床和研究进展。在本综述中,我们提供了一个历史视角,阐述了NEC定义和发病机制是如何演变成我们目前对NEC内型的理解的。我们还讨论了基于人工智能的方法如何影响我们对NEC及其他新生儿肠道损伤表型的风险因素、分类和预后的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd3a/11466774/c8b6493861d1/fped-12-1432808-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd3a/11466774/c8b6493861d1/fped-12-1432808-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd3a/11466774/c8b6493861d1/fped-12-1432808-g001.jpg

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JAMA Netw Open. 2024 May 1;7(5):e249643. doi: 10.1001/jamanetworkopen.2024.9643.
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Comparing Healthcare Needs in Extremely Low Birth Weight Infants With NEC and Spontaneous Intestinal Perforation.比较患有 NEC 和自发性肠穿孔的极低出生体重儿的医疗需求。
J Pediatr Surg. 2024 Sep;59(9):1759-1764. doi: 10.1016/j.jpedsurg.2024.03.006. Epub 2024 Mar 16.
3
Reassessing acquired neonatal intestinal diseases using unsupervised machine learning.
Diagnostic and Prognostic Value of Hematological Parameters in Necrotizing Enterocolitis: A Systematic Review.
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J Clin Med. 2025 Apr 7;14(7):2530. doi: 10.3390/jcm14072530.
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Adverse outcomes after red blood cell transfusion in very low birth weight infants in a resource-restricted hospital.资源受限医院中极低出生体重儿红细胞输血后的不良结局
Transfusion. 2025 May;65(5):897-908. doi: 10.1111/trf.18244. Epub 2025 Apr 7.
使用无监督机器学习重新评估获得性新生儿肠道疾病。
Pediatr Res. 2024 Jul;96(1):165-171. doi: 10.1038/s41390-024-03074-x. Epub 2024 Feb 27.
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Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age.22-24 孕周出生婴儿自发性肠穿孔的危险因素和流行病学。
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