新生儿坏死性小肠结肠炎患儿血清Galectin 3和IGF-1表达及临床意义  

Expression and Clinical Significance of Serum Galectin-3 and IGF-1 in Children with Neonatal Necrotizing Enterocolitis

作　　者：肖二明 金晓艳 杨常栓 XIAO Er-ming;JIN Xiao-yan;YANG Chang-shuan(Department of Neonatology,Langfang Maternal and Child Health Hospital,Hebei Langfang 065000,China;the Seventh Medical Center of PLA General Hospital,Beijing 100700,China)

机构地区：[1]廊坊市妇幼保健院新生儿科,河北廊坊065000 [2]解放军总医院第七医学中心,北京100700

出　　处：《现代检验医学杂志》2023年第2期166-170,共5页Journal of Modern Laboratory Medicine

基　　金：河北省重点科技研究计划(20180052)。

摘　　要：目的研究坏死性小肠结肠炎(necrotizing enterocolitis,NEC)患儿血清半乳糖凝集素3(Galectin-3,Gal-3)和胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)的表达及临床意义。方法选取2019年1月~2021年2月廊坊市妇幼保健院诊治的80例NEC患儿为研究对象(NEC组),根据NEC严重程度分为轻度NEC组(n=50)和重度NEC组(n=30),同期诊治的50例非NEC患儿为对照组。应用酶联免疫吸附实验检测血清Gal 3和IGF-1水平,比较各组间血清Gal-3和IGF-1表达差异。多因素Logistic回归分析影响重度NEC发生的因素,受试者工作曲线分析血清Gal-3和IGF-1及联合检测对重度NEC的诊断价值。结果NEC组血清Gal-3(5.24±0.79ng/ml)和IGF 1(51.67±16.34ng/ml)水平显著高于对照组(2.13±0.47ng/ml,117.42±31.73ng/ml),差异具有统计学意义(t=7.685,13.884,均P<0.001)。重度NEC组新生儿气腹征发生率(53.33%),MODS发生率(46.67%)及Gal-3水平(5.94±0.71ng/ml)明显高于轻度NEC组(4.00%,6.00%,4.82±0.79ng/ml),重度NEC组血清IGF-1水平(37.60±16.67ng/ml)明显低于轻度组(60.11±18.35ng/ml),差异均有统计学意义(t/χ^(2)=5.493~26.170,均P<0.001)。并发气腹征、并发MODS、Gal-3升高、IGF-1降低是影响重度NEC发生的独立危险因素(均P<0.05)。血清Gal-3,IGF-1联合检测对重度NEC诊断的曲线下面积(95%CI)为0.856(0.813~0.904),显著高于血清Gal-3和IGF-1单一指标检测的0.794(0.740~0.848)和0.760(0.713~0.809),差异具有统计学意义(Z=2.314,3.173,P=0.021,0.002)。结论NEC患儿血清Gal-3水平升高,IGF-1水平降低,两者与NEC疾病严重程度有关,是影响重度NEC发生的独立因素。Objective To study the serum Galectin-3(Gal-3)and insulin-like growth factor-1(IGF-1)in children with necrotizing enterocolitis(NEC)expression and clinical significance.Methods From January 2019 to February 2021,80 NEC children diagnosed and treated in Langfang Maternal and Child Health Hospital were selected as the research objects(NEC group).According to the severity of NEC,it was divided into mild group(n=50)and severe group(n=30).50 non-NEC children diagnosed and treated during the same period were selected as the control group.Serum Gal-3 and IGF-1 levels were detected by enzyme-linked immunosorbent assay.The expression difference of serum Gal-3 and IGF-1 among the three groups was compared.Multivariate Logistic regression analysis were used to analyze factors affecting the occurrence of severe NEC.Receiver operating curve analysis were used to analyze the diagnostic value of serum Gal-3,IGF-1 and combined detection in severe NEC.Results The levels of serum Gal-3(5.24±0.79 ng/ml)and IGF-1(51.67±16.34ng/ml)in NEC group were significantly higher than those in control group(2.13±0.47ng/ml,117.42±31.73ng/ml),with statistically significant differences(t=7.685,13.884,all P<0.001).The incidence of pneumoperitoneum(53.33%),MODS(46.67%)and Gal-3 level(5.94±0.71ng/ml)in severe NEC group were significantly higher than those in mild NEC group(4.00%,6.00%,4.82±0.79ng/ml),and the serum IGF-1 level(37.60±16.67ng/ml)in severe NEC group was significantly lower than that in mild NEC group(60.11±18.35ng/ml),with statistically significant differences(t/χ^(2)=5.493~26.170,all P<0.001).Combined pneumoperitoneum,combined MODS,increased Gal-3,and decreased IGF-1 were independent risk factors for the occurrence of severe NEC.The area under the curve(95%CI)of the combined detection of serum Gal-3 and IGF-1 for the diagnosis of severe NEC was 0.856(0.813~0.904),which was significantly higher than that of serum Gal-3 and IGF-1 single indicator detection 0.794(0.740~0.848)and 0.760(0.713~0.809)(Z=2.314,3.173,P=0.021,0.002).Conc

关 键 词：新生儿坏死性小肠结肠炎 半乳糖凝集素3 胰岛素样生长因子-1 

分 类 号：R574.5[医药卫生—消化系统] R392.11[医药卫生—内科学]