摘要
目的 探讨肠道脂肪酸结合蛋白(I-FABP)、受体相互作用蛋白激酶1(RIPK1)、自诱导分子(AI-2)检测对新生儿坏死性小肠结肠炎(NEC)的相关性。方法 回顾性选取2022年2月至2024年2月间由驻马店市中心医院新生儿重症医学科接诊的166例坏死性小肠结肠炎的新生儿为NEC组,另选取73例同期诊治的非消化系统疾病新生儿为非NEC组,比较NEC组和非NEC组及NEC组贝尔分期ⅡA、ⅡB患儿的I-FABP、RIPK1、AI-2;使用多因素Logistic回归分析新生儿NEC发生的影响因素;利用受试者工作曲线(ROC)分析I-FABP、RIPK1、AI-2检测对新生儿坏死性小肠结肠炎的临床诊断价值。结果 单因素分析显示,两组的性别、日龄、分娩方式、胎龄、产时宫内窘迫、喂养方式等一般资料比较,差异无统计学意义(P>0.05);NEC组肠壁积气、肠壁血流减少、肠壁变薄占比、D-二聚体(D-D)、白细胞介素-8(IL-8)、I-FABP、RIPK1高于非NEC组,AI-2低于非NEC组,差异有统计学意义(P<0.05)。ⅡA期患儿I-FABP、RIPK1低于ⅡB患儿,AI-2高于ⅡB患儿,差异有统计学意义(P<0.05)。经多因素Logistic分析,可见存在组肠壁积气、肠壁血流减少、肠壁变薄、D-D、IL-8、I-FABP、RIPK1升高是新生儿NEC发生的独立危险因素,存在AI-2升高是新生儿NEC发生的独立保护因素(P<0.05)。I-FABP、RIPK1、AI-2检测诊断新生儿NEC的ROC曲线下面积(AUC)为0.926,高于单一诊断(P<0.05)。结论 I-FABP、RIPK1、AI-2三者联合诊断对新生儿NEC的发生具有一定临床价值,可为该疾病的诊治提供新的参考。
Objective To study the correlation of intestinal fatty acid binding protein(I⁃FABP),receptor⁃interacting protein kinase 1(RIPK1),and autoinducible molecule 2(AI⁃2)in neonates with necrotiz⁃ing enterocolitis(NEC).Methods A total of 166 neonates with necrotizing enterocolitis were admitted to the Neonatal Intensive Care Unit of Zhumadian Central Hospital from February 2022 to February 2024 and were en⁃rolled in the NEC group,while 73 neonates without digestive system diseases were enrolled in the non⁃NEC group.I⁃FABP,RIPK1,and AI⁃2 were compared between the NEC group and the non⁃NEC group,and be⁃tween the NEC group with Bell stageⅡA andⅡB.Multivariate logistic regression was used to analyze the risk factors for neonatal NEC.The receiver operating curve(ROC)was used to analyze the clinical diagnostic value of I⁃FABP,RIPK1,and AI⁃2 in neonatal necrotizing enterocolitis.Results Univariate analysis revealed no sig⁃nificant differences in gender,age,delivery mode,gestational age,intrauterine distress during labor,and feed⁃ing patterns between the two groups(P>0.05).In contrast,the NEC group exhibited significantly higher levels of pneumatosis intestinae,decreased blood flow in the intestinal wall,thinner percentage of the intestinal wall,D⁃dimer(D⁃D),interleukin⁃8(IL⁃8),I⁃FABP,and RIPK1,with a significantly lower level of AI⁃2(P<0.05).Children in stageⅡA had significantly lower I⁃FABP and RIPK1 levels,and a significantly higher AI⁃2 level compared to those in stageⅡB(P<0.05).Multivariate logistic analysis indicated that pneumatosis intestinae,decreased blood flow in the intestinal wall,thinner percentage of the intestinal wall,and elevated levels of D⁃D,IL⁃8,I⁃FABP,and RIPK1 were independent risk factors for NEC,while increased levels of AI⁃2 were identi⁃fied as independent protective factors for NEC(P<0.05).The area under the ROC curve(AUC)of I⁃FABP,RIPK1,and AI⁃2 in diagnosing NEC was 0.926,higher than that of individual diagnoses(P<0.05).Conclusion The combined diagnosis of I⁃FABP,RIPK1,and AI⁃2 holds significant clinical value in predicting the occur⁃rence of neonatal NEC.This can offer a new reference point for diagnosing and treating this disease.
作者
王勇兵
左伟雪
王芸芸
WANG Yongbing;ZUO Weixue;WANG Yunyun(Department of Neonatal Intensive Care,Zhumadian Central Hospital,Zhumadian,Henan,China,463000)
出处
《分子诊断与治疗杂志》
2025年第8期1417-1420,共4页
Journal of Molecular Diagnostics and Therapy
基金
河南省医学科技攻关计划(联合共建项目)(LHCJ20220740)。
关键词
肠道脂肪酸结合蛋白
受体相互作用蛋白激酶
自诱导分子
坏死性小肠结肠炎
Intestinal fatty acid binding protein
Receptor⁃interacting protein kinases
Self⁃induc⁃ing molecules
Necrotizing enterocolitis
