新生儿坏死性小肠结肠炎患者血清CCL11和IRF5水平检测对临床诊断及预后价值研究  

Clinical Diagnostic and Prognostic Value of Serum CCL11 and IRF5 Level Testing in Neonatal Necrotizing Enterocolitis Patients

作　　者：马媛媛 冯茹清 王媛媛 MA Yuanyuan;FENG Ruqing;WANG Yuanyuan(Department of Neonatology,Zhangjiakou Maternal and Child Health Hospital,Hebei Zhangjiakou 075000,China;Department of Critical Care Medicine,Zhangjiakou Maternal and Child Health Hospital,Hebei Zhangjiakou 075000,China)

机构地区：[1]张家口市妇幼保健院新生儿科,河北张家口075000 [2]张家口市妇幼保健院重症医学科,河北张家口075000

出　　处：《现代检验医学杂志》2024年第5期146-151,共6页Journal of Modern Laboratory Medicine

基　　金：张家口市科学技术局2023年市级科技计划项目(项目编号:2322073D)

摘　　要：目的 探讨血清CC趋化因子配体11(CC chemokine ligand 11,CCL11)、干扰素调节因子5(interferon regulatory factor 5,IRF5)水平联合检测对新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)的诊断及预后价值。方法 收集2020年8月~2023年5月期间于张家口市妇幼保健院就诊的115例NEC患儿作为研究组,另选取同期健康新生儿92例作为对照组。治疗30天后,根据患儿的生存情况将其分为生存组(n=89)和死亡组(n=26)。采用酶联免疫吸附法(ELISA)检测各组血清CCL11和IRF5水平;收集并比较生存组和死亡组患儿临床资料;多因素Logistic回归分析新生儿发生NEC的影响因素;绘制受试者工作特征(ROC)曲线评估血清CCL11和IRF5水平对新生儿NEC的诊断及预后价值。结果 与对照组相比,研究组NEC患儿血清CCL11水平(1.41±0.62pg/ml vs 0.79±0.28pg/ml)、IRF5水平(5.34±2.16 pg/ml vs 3.29±1.43 pg/ml)明显升高,差异具有统计学意义(t=8.891,7.831,均P <0.001),且二者水平联合诊断新生儿NEC的AUC为0.898,敏感度为86.96%,二者联合优于CCL11和IRF5单独诊断(Z=2.747,2.921,P=0.006,0.004)。与生存组相比,死亡组NEC患儿Bell分期为Ⅱ~Ⅲ期占比(76.92%vs 42.70%)、喂养方式为配方奶喂养占比(61.54%vs 24.72%)、呼吸衰竭占比(34.62%vs 13.48%)、治疗方式为外科手术占比(53.85%vs 38.09%)显著升高(χ^(2)=9.429,13.596,4.688,5.956),出生体重(1.71±0.23kg vs 1.83±0.26kg)显著降低(t=2.122),差异具有统计学意义(均P <0.05)。与生存组相比,死亡组NEC患儿血清CCL11水平(2.14±1.23 pg/ml vs 1.20±0.44pg/ml)、IRF5水平(8.63±3.84 pg/ml vs 4.38±1.67 pg/ml)明显升高,差异具有统计学意义(t=6.052,8.178,均P <0.001)。多因素Logistic回归分析结果显示,Bell分期为Ⅱ~Ⅲ期(OR=1.725,95%CI=1.186~2.508)、配方奶喂养(OR=1.429,95%CI=1.018~2.006)、呼吸衰竭(OR=1.652,95%CI:1.121~2.435)、CCL11(OR=1.641,95%CI=1.056~2.551)、IRF5(OR=1.646,95%CI=1.082~2.504)是影响NEC患儿死亡的危险因素Objective To explore the diagnostic and prognostic value of combined detection of serum CC chemokine ligand 11(CCL11)and interferon regulatory factor 5(IRF5)levels for neonatal necrotizing enterocolitis(NEC).Methods A total of 115 children with NEC who visited Zhangjiakou Maternal and Child Health Hospital from August 2020 to May 2023 were collected as the study group,and 92 healthy newborns during the same period were selected as the control group.After 30 days of treatment,these patients were grouped into a survival group(n=89)and a death group(n=26)based on their survival status.Enzyme-linked immunosorbent assay(ELISA)method was applied to detect the levels of serum CCL11 and IRF5 in each group.Clinical data of children in the survival and death groups were collected and compared,and multivariate Logistic regression was applied to analyze the influencing factors of neonatal NEC occurrence.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic and prognostic value of serum CCL11 and IRF5 levels for neonatal NEC.Results Compared with the control group,the serum CCL11 level(1.41±0.62 pg/ml vs 0.79±0.28 pg/ml)and IRF5 level(5.34±2.16 pg/ml vs 3.29±1.43 pg/ml)in the study group were increased,and the differences were significant(t=8.891,7.831,all P<0.001).The area under the curve(AUC)of the combined diagnosis of two for neonatal NEC was 0.898,with a sensitivity of 86.96%,and the combination of the two was superior to the diagnosis of CCL11 and IRF5 alone(Z=2.747,2.921,P=0.006,0.004).Compared with the survival group,the percentage of children with NEC in the death group with Bell stage Ⅱ~Ⅲ(76.92%vs 42.70%),the percentage of children with feeding mode of formula feeding(61.54%vs 24.72%),percentage with respiratory failure(34.62%vs 13.48%),treatment by surgery(53.85%vs 38.09%)were higher(χ^(2)=9.429,13.596,4.688,5.956),but the birth weights(1.71±0.23 pg/ml vs 1.83±0.26 pg/ml)was lower(t=2.122),and the differences were statistically significant(all P<0.05),respectively.Compared wi

关 键 词：CC趋化因子配体11 干扰素调节因子5 新生儿坏死性小肠结肠炎 

分 类 号：R574.62[医药卫生—消化系统] R392.11[医药卫生—内科学]