AI-2、HBD在早产儿坏死性小肠结肠炎病情监测中的价值  

Value of AI-2 and HBD in Monitoring Condition of Necrotizing Enterocolitis in Premature Infants

作　　者：裴小瑜 李少芳 刘凯 PEI Xiaoyu;LI Shaofang;LIU Kai(Department of Neonatology,3201 Hospital,Hanzhong 723000,China)

机构地区：[1]三二○一医院新生儿科,陕西汉中723000

出　　处：《医学综述》2021年第8期1657-1661,共5页Medical Recapitulate

摘　　要：目的探讨粪便自诱导分子-2(AI-2)、粪便人β-防御素(HBD)在早产儿坏死性小肠结肠炎(NEC)中的水平及其监测病情变化的价值。方法选取2016年3月至2020年1月三二○一医院新生儿科收治的33例NEC早产儿作为NEC组,其中NEC诊断时定为急性期,再次开奶3 d后定为恢复期;选取同期41例非NEC早产儿作为非NEC组。采用酶联免疫吸附试验测定两组HBD水平,生物荧光检测法测定两组AI-2水平;分析两组肠道菌群紊乱情况,比较NEC急性期组、NEC恢复期组、非NEC组的纲/属水平香农-威纳指数(Shannon-Weiner指数)和前三位的菌群丰度情况,以及HBD1、HBD2、AI-2水平。结果经对症支持治疗后,本研究纳入病例均康复出院,无死亡病例出现。NEC组肠道菌群紊乱发生率高于非NEC组[81.82%(27/33)比41.46%(17/41)](P<0.01),NEC组肠道菌群紊乱分级优于非NEC组(P<0.01)。NEC恢复期组纲水平、种属水平Shannon-Weiner指数低于非NEC组和NEC急性期组(P<0.05)。NEC急性期组变形菌门、厚壁菌门相对丰度高于非NEC组,而拟杆菌门相对丰度低于非NEC组(P<0.05);NEC恢复期组变形菌门、拟杆菌门相对丰度均低于非NEC组和NEC急性期组,而厚壁菌门相对丰度高于非NEC组(P<0.05)。NEC急性期组克雷伯菌属相对丰度高于非NEC组,而肠杆菌属相对丰度低于非NEC组(P<0.05);NEC恢复期组克雷伯菌属相对丰度低于NEC急性期组和非NEC组,而肠杆菌属相对丰度高于NEC急性期组和非NEC组(P<0.05)。NEC急性期组HBD1、HBD2及AI-2水平均低于非NEC组(P<0.05);NEC恢复期组HBD1、HBD2及AI-2水平均低于非NEC组和NEC急性期组(P<0.05)。结论NEC患儿AI-2及HBD的表达水平较低,AI-2及HBD在NEC早产儿病情监测中具有一定的潜在价值。Objective To investigate the levels of fecal autoinducer-2(AI-2)and fecal humanβ-defensin(HBD)in preterm infants with necrotizing enterocolitis(NEC)and their clinical significance.Methods A total of 33 cases of NEC premature infants admitted to the Department of Neonatology of 3201 Hospital from Mar.2016 to Jan.2020 were included as a NEC group,in which NEC at diagnosis was defined as acute stage,and 3 days after re-weaning was defined as recovery stage;41 cases of non-NEC premature infants in the same period were included as a non-NEC group.The levels of HBD and AI-2 in the two groups were measured by enzyme-linked immunosorbent assay and biological fluorescence assay respectively.The intestinal flora disorder of the two groups was analyzed,and the Shannon-Weiner index and the top three flora abundance,as well as the levels of HBD1,HBD2 and AI-2 in the NEC acute stage group,NEC recovery stage group and non-NEC group were compared.Results After symptomatic support treatment,all the patients in this study were recovered and discharged,and no death occurred.The incidence of intestinal flora disorder in the NEC group was higher than that in the non-NEC group[81.82%(27/33)vs 41.46%(17/41)](P<0.01).The grade of intestinal flora disorder in the NEC group was better than that in the non-NEC group(P<0.01).the Shannon-Weiner indexes of class level and species level in the recovery stage NEC group was lower than those in the non-NEC group and acute NEC group(P<0.05).The relative abundance of Proteus and Firmicutes in the NEC acute stage group was higher than that in the non-NEC group,while the relative abundance of Bacteroides was lower than that in the non-NEC group(P<0.05);the relative abundance of Proteus and bacteroides in the NEC recovery stage group was lower than that in the non-NEC group and NEC acute stage group,while the relative abundance of Firmicutes was higher than that in the non-NEC group(P<0.05).The relative abundance of Klebsiella in the acute NEC group was higher than that in the non-NEC group,while the

关 键 词：坏死性小肠结肠炎 早产儿 自诱导分子-2 人β-防御素 

分 类 号：R574.62[医药卫生—消化系统]