白细胞介素-17对坏死性小肠结肠炎早产儿病死率的预测价值

Value of interleukin-17 in predicting mortality rate of premature infants with necrotizing enterocolitis

目的评估监测循环血白细胞介素-17（IL-17）预测坏死性小肠结肠炎（NEC）早产儿60d病死率的价值。方法回顾性纳入85例外科（n=35）或内科（n=50）治疗的NEC新生儿。在诊断NEC及术前检测血清IL-17水平,评估其预测价值。结果 60d后病死率为20%（17/85）,其中5例（10%）为内科治疗组,12例（34%）为外科治疗组。IL-17与30d后病死率显著相关（OR1.38;95%CI：1.14-1.67;P=0.001）。外科治疗组术前IL-17水平（27-7 500pg/mL,中位数2 625pg/mL）较内科治疗组（中位数156pg/mL）明显更高（P〈0.01）。内科治疗组和外科治疗组NEC在曲线下面积的区别为0.82（95%CI：0.74-0.90）,IL-17有检测意义的临界值为1 783pg/mL（敏感度为90.5%,特异度为59.2%）。结论血清IL-17水平与NEC新生儿60d病死率相关。

Objective To evaluate the value of monitoring circular blood interleukin（IL）-17 for predicting 60 dmortality rate in premature infants with necrotizing enterocolitis（NEC）.Methods A total of 85 neonates with surgically or medically treated NEC were retrospectively included.Serum IL-17 level was detected in diagnosing NEC and before preparing operation for evaluating its predictive value.Results The mortality rate after 60 dwas 20%（17/85）,in which 5（10%）was in the medical treatment group and12（34%）in the surgical treatment group.The IL-17 level was significantly correlated with mortality rate after 30 d [odds ratio（OR）：1.38;CI：1.14-1.67;P=0.001].The preoperative IL-17 level in the surgical treatment group was 27-7 500pg/mL（median 2 625pg/mL）,which was significantly higher than mean 156pg/mL in the medical treatment group.The difference in the area under curve（AUC）between the medical treatment group and surgical treatment group was 0.82（CI：0.74-0.90）.The critical value of IL-17 for detection significance was 1 783pg/mL（sensitivity was 90.5%,specificity was 59.2%）.Conclusion Serum IL-17 level is correlated with the mortality rate after 60 d.