血清Smad7及TSLP在新生儿坏死性小肠结肠炎诊断及病情判断中的价值

Value of serum Smad7 and TSLP in the diagnosis and disease condition judgment of neonatal necrotizing enterocolitis

目的探讨血清Smad同源物7(Smad7)、胸腺基质淋巴生成素(TSLP)在新生儿坏死性小肠结肠炎(NEC)诊断及病情判断中的价值。方法选取2021年4月至2023年4月该院收治的98例确诊为NEC的患儿为观察组,根据病情严重程度分为重症组(38例)和轻症组(60例)。另选取同期在该院出生的98例健康新生儿为对照组。采用实时荧光定量聚合酶链反应(qRT-PCR)检测血清Smad7相对表达量,采用酶联免疫吸附试验检测血清TSLP水平;采用Spearman相关分析NEC患儿血清Smad7、TSLP水平与病情严重程度的相关性;采用受试者工作特征(ROC)曲线分析血清Smad7、TSLP水平对重症NEC的诊断价值。结果与对照组比较,观察组血清Smad7、TSLP水平明显升高,差异均有统计学意义(P<0.05)。与轻症组比较,重症组血清Smad7、TSLP水平明显升高,差异均有统计学意义(P<0.05)。血清Smad7、TSLP水平与病情严重程度均呈正相关(r=0.486,P<0.001;r=0.421,P<0.001)。血清Smad7、TSLP诊断重症NEC的曲线下面积(AUC)分别为0.800、0.750,二者联合检测诊断重症NEC的AUC为0.850,二者联合检测的AUC明显大于血清Smad7、TSLP单独检测的AUC(Z=2.074,P=0.038;Z=1.974,P=0.048)。结论NEC患儿的血清Smad7、TSLP水平均上调,且与病情严重程度关系密切,二者联合检测对重症NEC具有较高的诊断价值。

Objective To study the value of serum Smad homolog 7(Smad7)and thymic stromal lymphopoietin(TSLP)in the diagnosis and disease condition judgment of neonatal necrotizing enterocolitis(NEC).Methods A total of 98 children with NEC who were admitted to Hebei Petro China Central Hospital from April 2021 to April 2023 were enrolled as observation group.According to the severity of the disease,they were divided into the severe group with 38 children and the mild group with 60 children.Another 98 cases of healthy newborn were selected as control group during the same period.Real-time fluorescent quantitative polymerase chain reaction(qRT-PCR)was used to detect the relative expression of Smad7 in serum,and enzyme-linked immunosorbent assay was used to detect the serum level of TSLP.Spearman method was used to analyze the correlation between serum Smad7,TSLP levels and the severity of NEC.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum Smad7 and TSLP levels in severe NEC.Results Compared with the control group,the serum levels of Smad7 and TSLP in the observation group increased significantly(P<0.05).Compared with the mild group,the serum levels of Smad7 and TSLP in the severe group increased significantly(P<0.05).The levels of serum Smad7 and TSLP correlated positively with the severity of the disease(r=0.486,P<0.001;r=0.421,P<0.001).The area under the curve(AUC)of serum Smad7 and TSLP in the diagnosis of severe NEC were 0.800 and 0.750 respectively.The AUC of combined detection of serum Smad7 and TSLP in the diagnosis of severe NEC was 0.850,which was significantly greater than that of serum Smad7 and TSLP alone(Z=2.074,P=0.038;Z=1.974,P=0.048).Conclusion The serum levels of Smad7 and TSLP both up-regulate in children with NEC,which relate closely to the severity of the disease.The combined detection of Smad7 and TSLP has a high value in the diagnosis of severe NEC.