新生儿坏死性小肠结肠炎治疗中炎症指标的变化分析

Analysis of the Changes of Inflammatory Indicators in the Treatment of Neonatal Necrotizing Enterocolitis

目的分析在新生儿坏死性小肠结肠炎(neonatal necrotizing enterocoltis,NEC)的治疗中炎症指标的变化情况。方法选取NEC患儿71例,依照修正Bell-NEC分级法将这71例NEC患儿分为Ⅰ期组(24例)、Ⅱ期组(29例)和Ⅲ期组(18例)。有24例采取手术治疗,其中Ⅰ期1例、Ⅱ期6例、Ⅲ期17例,有47例保守治疗,其中Ⅰ期23例、Ⅱ期23例、Ⅲ期1例。对3组干预前、干预后首日及治疗恢复期中的中性粒细胞(NLR)、白细胞(WBC)、血小板计数(PLT)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)等炎症指标进行检测并分析。结果Ⅰ期组干预前与干预后首日WBC、PLT、NLR、hs-CRP、PCT水平比较,差异无统计学意义(P>0.05);干预前与治疗恢复期WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05);干预后首日与治疗恢复期比较,差异有统计学意义(P<0.05)。Ⅱ期组干预前与干预后首日WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05);干预前与治疗恢复期WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05),干预后首日与治疗恢复期WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05)。Ⅲ期组干预前与干预后首日WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05);干预前与治疗恢复期WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05);干预后首日与治疗恢复期WBC、PLT、NLR、hs-CRP、PCT水平比较,差异有统计学意义(P<0.05)。WBC、NLR、hs-CRP、PCT与Bell-NEC分级之间呈正相关性;PLT与Bell-NEC分级之间呈负相关性。结论对WBC、hs-CRP、PLT、PCT、NLR等炎症指标的变化实施监测有助于NEC疾病Ⅱ、Ⅲ期的诊断。

Objective To analyze the change of inflammatory index in the treatment of necrotiziNLR enterocolitis(NEC).Methods A total of 71 NEC newborns were sele cted,and these 71 NEC newborns were divided into stageⅠ(24),stage grouP(29)and stage(18)according to the modified Bell stage.There were 24 patients,including 1 in stageⅠ,6,17,and 47 with conservative treatment,including 23 in stageⅠ,23,and 1.Inflammatory indicators such as neutrophils(NLR),leukocytes(WBC),platelet number(PLT),procalcitonin(PCT),and hypersensitive C-reactive protein(hs-CRP)on the first day after intervention and during the treatment recovery period of the 3 groups were tested and analyzed.Results The WBC,PLT,NLR,hs-CRP,and PCT levels were compared between the phaseⅠgroups before intervention and on the first day after the intervention(P>0.05),Comparison of the convalescent WBC,PLT,NLR,hs-CRP,and PCT levels obtained before the intervention and the treatment period(P<0.05),Comparison between the first day after the intervention and the treatment recovery period(P<0.05);Comparison of WBC,PLT,NLR,hs-CRP,and PCT levels before the intervention and on the first day after the phase groupof the intervention(P<0.05),Comparison of the convalescent WBC,PLT,NLR,hs-CRP,and PCT levels obtained before the intervention and the treatment period(P<0.05),The ison of WBC,PLT,NLR,hs-CRP,and PCT on the first day after intervention and treatment(P<0.05);Comparison of WBC,PLT,NLR,hs-CRP,and PCT levels before the intervention and on the first day after the phase grouPof the intervention(P<0.05),Comparison of the convalescent WBC,PLT,NLR,hs-CRP,and PCT levels obtained before the intervention and the treatment period(P<0.05),The ison of WBC,PLT,NLR,hs-CRP,and PCT on the first day after intervention and treatment(P<0.05);A positive correlation observed between WBC,NLR,hs-CRP,PCT and Bell-NEC grade levels(P<0.05);A negative correlation occurred between the PLT and the Bell-NEC grade(P<0.05).Conclusion Monitoring the changes of WBC,hs-CRP,PLT,PCT and NLR is helpful to the diagnosis of NEC disease and stage.