Li Wenmei, Sun Wenqiang, Sun Zexi, Wang Huawei, Zhu Xueping
Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China.
Sci Rep. 2025 Jan 25;15(1):3209. doi: 10.1038/s41598-025-87544-0.
This study investigated the correlation between quantitative echocardiographic characteristics within 3 days of birth and necrotizing enterocolitis (NEC) and its severity in preterm infants. A retrospective study was conducted on 168 preterm infants with a gestational age of < 34 weeks. Patients were categorized into NEC and non-NEC groups. Clinical and quantitative cardiac ultrasound characteristics were compared using univariate and multivariate analyses. Additionally, the NEC group was divided into two subgroups according to Bell's staging, and the quantitative echocardiographic characteristics were compared. Overall, 141 preterm infants were included. Percentage of antenatal glucocorticosteroid administrations was lower in the NEC group than those in the control group. Umbilical vein cannulation, antibiotic duration, total red blood cell infusion, duration of total parenteral and total enteral nutrition, respiratory failure, hemodynamically significant patent ductus arteriosus, anemia, neutropenia, hyperbilirubinemia were significantly higher than those in the control group. The maximum shunt velocity and differential pressure (P) on the pulmonary side of the arterial conduit were significantly lower, whereas the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were significantly higher in the NEC group. Antenatal glucocorticoid use and umbilical vein cannulation were protective factors against NEC. Anemia, hyperbilirubinemia, and lower P were risk factors for NEC. P was significantly lower and LVFS and LVES were significantly higher in preterm infants in the NEC II B-III group than those in the NEC II A group. Preterm infants with NEC have significant abnormalities in some quantitative features on echocardiography within 3 days after birth, and a lower P may be a risk factor for the development of NEC.
本研究调查了出生3天内超声心动图定量特征与坏死性小肠结肠炎（NEC）及其在早产儿中的严重程度之间的相关性。对168例孕周<34周的早产儿进行了一项回顾性研究。将患者分为NEC组和非NEC组。采用单因素和多因素分析比较临床和心脏超声定量特征。此外，根据贝尔分期将NEC组分为两个亚组，并比较超声心动图定量特征。总体而言，纳入了141例早产儿。NEC组产前糖皮质激素给药的百分比低于对照组。脐静脉插管、抗生素使用时间、总红细胞输注量、全胃肠外营养和全肠内营养持续时间、呼吸衰竭、血流动力学显著的动脉导管未闭、贫血、中性粒细胞减少、高胆红素血症均显著高于对照组。NEC组动脉导管肺动脉侧的最大分流速度和压差（P）显著降低，而左心室射血分数（LVEF）和左心室缩短分数（LVFS）显著升高。产前使用糖皮质激素和脐静脉插管是预防NEC的保护因素。贫血、高胆红素血症和较低的P是NEC的危险因素。NEC II B-III组早产儿的P显著低于NEC II A组，LVFS和左心室舒张末期内径（LVES）显著高于NEC II A组。患有NEC的早产儿在出生后3天内超声心动图的一些定量特征存在显著异常，较低的P可能是NEC发生的危险因素。
