摘要
目的 分析血清淀粉样蛋白A(SAA)、白细胞介素-8(IL-8)在新生儿坏死性小肠结肠炎(NEC)患儿中的表达,并探讨两指标与患儿临床预后的关系。方法 收集2020年6月至2022年6月南阳市第一人民医院儿科收治的126例新生儿NEC患儿进行巢式病例对照研究,进行60 d的随访,以随访期间患儿病死(全因死亡)的18例为病例组,其他108例为对照组。采用散射比浊法测定血清SAA水平,免疫荧光发光法测定血清IL-8水平;采用log-rank法对不同临床资料特征患儿生存时间分布的差异进行检验;血清SAA、IL-8与预后不良的关系采用Cox比例风险回归分析。结果 不同Bell-NEC分期、呼吸衰竭情况、治疗方式的NEC患儿生存期比较,差异有统计学意义(P<0.05);不同性别、胎龄、窒息情况、宫内窘迫情况、发病时间、休克情况、肾功能损害情况、其他并发症情况的NEC患儿生存期比较,差异无统计学意义(P>0.05);病例组NEC确诊时中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)、血清SAA、IL-8水平均高于对照组(P<0.05)。经Cox回归分析显示,无论是否调整混杂因素,血清SAA、IL-8与新生儿NEC患儿预后有关(P<0.05)。结论 血清SAA、IL-8高表达提示新生儿NEC患儿预后不良。
Objective To analyze the expression of serum amyloid A(SAA)and interleukin-8(IL-8)in neonates with necrotizing enterocolitis(NEC),and to explore the relationship between the two indexes and the clinical prognosis of the children.Methods A nested case-control study was conducted on 126 neonates with NEC admitted to the Department of Pediatrics of Nanyang First People’s Hospital from June 2020 to June 2022,and a 60-day follow-up was conducted.The 18 patients who died of illness(all-cause death)during the follow-up period were taken as the case group,and the other 108 patients as the control group.The levels of serum SAA and IL-8 were measured by nephelometry and immunofluorescence.Log-rank method was used to test the difference of survival time distribution of children with different clinical data characteristics.The relationship between serum SAA,IL-8 and poor prognosis was analyzed by Cox proportional risk regression.Results Compared with Bell-NEC stage,respiratory failure condition and treatment methods,the survival time of NEC children was statistically significant(P<0.05).There was no statistically significant difference in the survival time of NEC children with different gender,gestational age,asphyxia,intrauterine distress,onset time,shock,renal impairment and other complications(P>0.05).The neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP),serum SAA and IL-8 in the case group were higher than those in the control group(P<0.05).Cox regression analysis showed that serum SAA and IL-8 were related to the prognosis of neonatal NEC,regardless of whether the confounding factors were adjusted(P<0.05).Conclusion The high expression of serum SAA and IL-8 suggests poor prognosis in neonates NEC.
作者
许俊
张金玉
王东丽
丁若雨
XU Jun;ZHANG Jinyu;WANG Dongli;DING Ruoyu(Department of Pediatrics,Nanyang First People’s Hospital,Nanyang 473000,China)
出处
《河南医学研究》
CAS
2023年第9期1640-1644,共5页
Henan Medical Research
