NEC新生儿发病危险因素分析及血清I-FABP、CRP、IL-8水平变化

Risk factors of neonatal necrotizing enterocolitis and changes of serum I-FABP,CRP,IL-8

目的探讨新生儿坏死性小肠结肠炎(NEC)发病的危险因素,并观察患儿血清肠脂肪酸结合蛋白(I-FABP)、C反应蛋白(CRP)和白细胞介素-8(IL-8)水平变化及临床意义。方法选取2014年5月至2016年5月该院收治的87例NEC新生儿(观察组)和120例患有黄疸的非NEC新生儿(对照组)为研究对象,对两组新生儿NEC发病危险因素进行统计分析,检测两组新生儿血清I-FABP、CRP及IL-8水平,并采用受试者工作特征(ROC)曲线判断各指标在NEC诊断中的价值。结果两组新生儿产时窒息、母乳喂养、新生儿呼吸窘迫综合征、肠道畸形及服用微生物制剂比例比较,差异均有统计学意义(P<0.05)。观察组新生儿血清I-FABP、CRP及IL-8水平均明显高于对照组(P<0.05),且观察组中随着病变分期的增加,患儿血清I-FABP、CRP及IL-8水平也明显升高(P<0.05)。ROC曲线分析显示,I-FABP、CRP、IL-8诊断NEC的最佳临界值为I-FABP>1.27μg/L、CRP>9.23 mg/L、IL-8>16.84 ng/L,三者诊断灵敏度分别为75.90%、86.20%、65.50%,特异度分别为90.00%、65.00%、70.00%。结论产时窒息及合并症是NEC发病的危险因素;血清I-FABP、CRP及IL-8水平检测对NEC的诊断和病变分期判断具有一定参考价值。

Objective To explore the risk factors of neonatal necrotizing enterocolitis(NEC),and observe the serum fatty acid binding protein(I-FABP),C reactive protein(CRP)and lnterleukin-8(IL-8)levels and their clinical significance.Methods A total of 87 neonates with NEC(the observation group)and 120 neonates without NEC(the control group)in this hospital from May 2014 to May 2016 were enrolled in this study.The risk factors of NEC were analyzed.Levels of I-FABP,CRP and IL-8 were detected in the two groups and the diagnosis values were analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in rates of intrapartum asphyxia,breast feeding,respiratory distress syndrome,intestinal deformity and probiotics usage between the two groups(P<0.05).The levels of serum I-FABP,CRP and IL-8 in the observation group were significantly higher than those in the control group(P<0.05).And the levels of I-FABP,CRP and IL-8 significantly increased with the increase of pathological stage in the obseroation group(P<0.05).ROC curve showed the best cutoff value of I-FABP,CRP,IL-8 as predicting factors for diagnosing NEC were I-FABP>1.27μg/L,CRP>9.23 mg/L,IL-8>16.84 ng/L with sensitivity 75.90%,86.20%,65.50%and specificity 90.00%,65.00%,70.00%,respectively.Conclusion Asphyxia and its comorbidities are risk factors for NEC.The detection of serum I-FABP,CRP and IL-8 levels has certain reference value for the diagnosis of NEC and the judgment of lesion stage.