肠道菌群水平与早产极低出生体重新生儿坏死性小肠结肠炎预后的相关性  

Correlation analysis between intestinal flora level and prognosis of necrotizing enterocolitis in premature very low birth weight newborns

作　　者：贾益 应海燕 李少芳 JIA Yi;YING Hai-yan;LI Shao-fang(Department of Neonatology,Hanzhong 3201 Hospital,Hanzhong 723000,Shaanxi,China)

机构地区：[1]汉中三二〇一医院新生儿科,陕西汉中723000

出　　处：《川北医学院学报》2023年第12期1664-1667,共4页Journal of North Sichuan Medical College

基　　金：陕西省西安市科技计划项目(20YxYJ0006)。

摘　　要：目的:分析肠道菌群水平与早产极低出生体重新生儿坏死性小肠结肠炎(NEC)预后的相关性。方法:选取105例早产极低出生体重新生儿合并NEC患儿为研究对象并设为NEC组,按照患儿预后,将存活患儿分为存活组(n=74)与死亡组(n=31),并选取同期30例未合并NEC的早产极低出生体重儿纳入对照组。比较NEC患儿与对照组儿童实验室指标、炎性因子水平、肠道菌群水平,并比较两组NEC患儿治疗后肠道菌群水平、炎性因子水平。结果:NEC组大便潜血阳性、HCO_(3)^(-)<21 mmol/L、血培养阳性、C-反应蛋白>10 mg/L、血小板计数>100×10^(9)/L、白细胞计数<5×10^(9)/L、白细胞计数>20×10^(9)/L比例均高于对照组,差异有统计学意义(P<0.05)。NEC组白细胞介素1β(IL-1β)、IL-6、IL-10及肿瘤坏死因子α(TNF-α)均高于对照组,差异有统计学意义(P<0.05)。NEC组厚壁菌门、梭菌纲丰度及Shannon指数均高于对照组,其变形菌门丰度、γ-变形菌纲丰度均低于对照组,差异有统计学意义(P<0.05)。NEC组105例患儿中,存活74例,死亡31例,死亡率29.52%。存活组大便潜血阳性、HCO_(3)^(-)<21 mmol/L、血培养阳性、C-反应蛋白>10 mg/L、白细胞计数<5×10^(9)/L、白细胞计数>20×10^(9)/L比例均低于死亡组,IL-1β、IL-6、IL-10、TNF-α水平均低于死亡组,厚壁菌门、梭菌纲丰度及Shannon指数均低于死亡组,变形菌门丰度、γ-变形菌纲丰度高于死亡组,差异有统计学意义(P<0.05)。结论:合并NEC的早产极低出生体重儿普遍存在肠道功能、血常规相关指标异常及炎症反应、肠道菌群失调,且上述变化越显著,患儿预后越差。Objective:To analyze the correlation between intestinal flora level and prognosis of necrotizing enterocolitis(NEC)in premature very low birth weight newborns.Methods:105 premature very low birth weight newborns with NEC were selected and assigned to the NEC group.According to the prognosis of the children,the surviving children were included in the survival group(n=74)and the dead children were included in the death group(n=31).At the same time,30 premature very low birth weight infants without NEC were selected as the control group.The laboratory indicators,inflammatory factor,and intestinal flora levels were compared between NEC group and the control group,and the intestinal flora and inflammatory factors levels after treatment were compared between the two groups of NEC children.Results:The fecal occult blood,HCO_(3)^(-)<21 mmol/L,positive blood culture,C-reactive protein>10 mg/L,platelet count>100×10^(9)/L,white blood cell count<5×10^(9)/L and white blood cell count>20×10^(9)/L in NEC group were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of interleukin-1β(IL-1β),IL-6,IL-10 and tumor necrosis factor-α(TNF-α)in NEC group were higher than those in control group(P<0.05).The abundance of sclerenchyma,Clostridium and Shannon index in NEC group were higher than those in the control group,while the abundance of Proteobacteria andγ-Proteobacteria were all lower than those in the control group,with statistical significance(P<0.05).Of the 105 children in NEC group,74 survived and 31 died,with a mortality rate of 29.52%.The ratio of fecal occult blood,HCO_(3)^(-)<21 mmol/L,positive blood culture,C-reactive protein>10 mg/L,white blood cell count<5×10^(9)/L,white blood cell count>20×10^(9)/L in survival group was lower than that in death group,and its IL-1β,IL-6,IL-10 and TNF-αwere lower than those in death group.The abundance of sclerenchyma,Clostridium and Shannon index in survival group were lower than those in the death group,and the abundance

关 键 词：肠道菌群 极低出生体重 坏死性小肠结肠炎 预后 

分 类 号：R722.1[医药卫生—儿科]