CXCL5基因多态性及巨细胞病毒感染与新生儿坏死性小肠结肠炎临床结局的关系

Relationship between CXCL5 gene polymorphism, cytomegalovirus infection and clinical outcomes of neonatal necrotizing enterocolitis

目的研究CXCL5基因多态性及巨细胞病毒(CMV)感染与新生儿坏死性小肠结肠炎(NEC)临床结局的相关性。方法选择2017年1月-2020年6月西昌市人民医院儿科收治的183例NEC患儿为研究对象进行前瞻性研究,采集临床资料并完善CXCL5-156 G/C基因多态性和CMV感染率等检查,在此基础上给予个体治疗并随访预后,根据结果将患儿分为死亡组47例和存活组136例,比较两组临床资料和各项检查结果,分析患儿预后的影响因素。结果两组NEC患儿胎龄、出生时体质量、新生儿脑出血、CMV感染、肠穿孔、感染性休克、C-反应蛋白、白细胞计数、血小板计数、机械通气、NEC分期3期、CXCL5-156 G/C基因型和CXCL5-156 C等位基因分布比较差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,CMV感染、NEC分期3期和CXCL5-156 C等位基因是NEC患儿死亡的影响因素(P<0.05),出生时体质量为NEC患儿的保护因素(P<0.05)。结论NEC患儿死亡风险较高且CMV感染和CXCL5-156 G/C基因多态性均为影响患儿预后的影响因素。

OBJECTIVE To study the correlation between CXCL5 gene polymorphism,cytomegalovirus(CMV)infection and clinical outcomes of neonatal necrotizing enterocolitis(NEC).METHODS 183 children with NEC admitted to the department of pediatrics of Xichang People’s Hospital from Jan.2017 to Jun.2020 were selected as the research subjects for prospective research.The clinical data were collected,and the examinations such as CXCL5-156 G/C gene polymorphism and CMV infection rate were complemented.Individualized treatment was performed and the prognosis was followed up.According to the prognosis results,the children were divided into 47 cases of death group and 136 cases of survival group.The clinical data and examination results were compared between the two groups,and the factors affecting the prognosis of children were analyzed.RESULTS There were significant differences in the gestational age,birth weight,neonatal cerebral hemorrhage,CMV infection,intestinal perforation,septic shock,C-reactive protein,white blood cell count,platelet count,mechanical ventilation,NEC stage 3,CXCL5-156 G/C genotype and CXCL5-156 C allele distribution between the two groups(P<0.05).Multivariate logistic regression analysis showed that CMV infection,NEC stage 3 and CXCL5-156 C allele were the influencing factors of death in children with NEC(P<0.05),and birth weight was the protective factor of children with NEC(P<0.05).CONCLUSION The risk of death in children with NEC was higher,and CMV infection and CXCL5-156 G/C gene polymorphism were the influencing factors of the prognosis in children.