血清抵抗素、肿瘤坏死因子α表达水平与新生儿坏死性小肠结肠炎预后的相关性  

Correlation between serum resistin and tumor necrosis factor-αexpression and prognosis of neonatal necrotizing enterocolitis

作　　者：胡月 张拓慧 王蕾 HU Yue;ZHANG Tuo-hui;WANG Lei(Department of Pediatrics,Beijing Daxing District People's Hospital,Beijing 102600,China;Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Children's Health Center,Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]北京市大兴区人民医院儿科,北京102600 [2]首都医科大学附属北京妇产医院,北京100026 [3]首都儿科研究所附属儿童医院儿童保健中心,北京100020

出　　处：《临床和实验医学杂志》2025年第5期527-530,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金(编号:210100323)。

摘　　要：目的回顾性探讨新生儿坏死性小肠结肠炎(NEC)血清抵抗素、肿瘤坏死因子α(TNF-α)表达水平与患儿预后的关系。方法回顾性选取2019年2月至2020年5月北京市大兴区人民医院收治的92例NEC患儿为NEC组,根据临床分级标准将其分为NECⅡ期组53例和NECⅢ期组39例。选取86名未发生NEC的同期出生的新生儿作为对照组。检测并比较NEC组和对照组的血清Resistin、TNF-α水平;并采用受试者操作特征(ROC)曲线分析Resistin、TNF-α水平对NEC的预测价值。根据预后情况将NEC组患儿分为预后不良组(n=12)和预后良好组(n=80)。采用单因素和多因素Logistic回归分析对影响NEC患儿预后的因素进行分析。结果NECⅢ期组血清Resistin、TNF-α水平分别为(26.31±4.26)ng/mL、(30.24±3.14)ng/dL,均高于NECⅡ期组[(15.37±3.35)ng/mL、(21.31±3.62)ng/dL]和对照组[(13.78±3.18)ng/mL、(18.46±5.45)ng/dL],NECⅡ期组患儿血清Resistin、TNF-α水平均高于对照组,差异均有统计学意义(P<0.05)。血清Resistin、TNF-α及二者联合预测NEC的曲线下面积(AUC)分别为0.896、0.819、0.952,特异度分别为82.6%、65.1%、97.7%,敏感度分别为85.9%、85.9%、78.3%。预后不良组NEC患儿败血症患儿比例、血清Resistin、TNF-α水平分别为33.33%、(28.64±4.34)ng/mL、(34.86±4.12)ng/dL,均高于预后良好组[7.50%、(14.82±3.17)ng/mL、(20.03±3.21)ng/dL],发病前喂养、口服益生菌患儿比例分别为33.33%、16.67%,均低于预后良好组(67.50%、75.00%),差异均有统计学意义(P<0.05)。败血症、Resistin是影响NEC患儿预后不良的高危因素(P<0.05),发病前喂养是NEC患儿预后不良的保护因素(P<0.05)。结论NEC患儿血清Resistin、TNF-α表达水平随病情加重呈明显升高趋势,对于NEC诊断及预后评价可能有重要价值。Objective To explore the relationship between the levels of serum resistin and tumor necrosis factor-α(TNF-α)and the prognosis of neonatal necrotizing enterocolitis(NEC).Methods A total of 92 children with NEC admitted to Beijing Daxing District People's Hospital from February 2019 to May 2020 were retrospectively selected as the NEC group.According to the clinical grading standard,they were divided into 53 cases of NEC stageⅡgroup and 39 cases of NEC stageⅢgroup.Another 86 neonates born in the same period without NEC were selected as the control group.The levels of serum resistin and TNF-αin NEC group and control group were detected and compared.The predictive value of resistin and TNF-αlevels for NEC was analyzed by receiver operating characteristic(ROC)curve.According to the prognosis,children in NEC group were divided into the poor prognosis group(n=12)and the good prognosis group(n=80).The factors affecting the prognosis of children with NEC were analyzed using univariate and multivariate Logistic regression analysis.Results The levels of serum resistin and TNF-αin NEC stageⅢgroup were(26.31±4.26)ng/mL and(30.24±3.14)ng/dL,respectively,which were higher than those in NEC stageⅡgroup[(15.37±3.35)ng/mL,(21.31±3.62)ng/dL]and the control group[(13.78±3.18)ng/mL,(18.46±5.45)ng/dL],the levels of serum resistin and TNF-αin NEC stageⅡgroup were higher than those in control group,the differences were statistically significant(P<0.05).The area under the curve(AUC)of serum resistin,TNF-αand their combination in predicting NEC were 0.896,0.819 and 0.952,respectively.The specificity were 82.6%,65.1%and 97.7%,and the sensitivity were 85.9%,85.9%and 78.3%,respectively.The proportion of children with sepsis,serum resistin and TNF-αlevels in the poor prognosis group were 33.33%,(28.64±4.34)ng/mL and(34.86±4.12)ng/dL,respectively,which were higher than those in the good prognosis group[7.50%,(14.82±3.17)ng/mL and(20.03±3.21)ng/dL],the proportion of children with feeding and oral probiotics before o

关 键 词：坏死性小肠结肠炎 抵抗素 肿瘤坏死因子Α 预后 新生儿 

分 类 号：R722.1[医药卫生—儿科]