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| 血清标志物在需手术治疗的新生儿坏死性小肠结肠炎患儿中的变化 |
| Changes in serum markers in children with neonatal necrotizing enterocolitis requiring surgical treatment |
| 投稿时间：2019-10-01 |
| DOI：10.3969/j.issn.1000-0399.2020.03.012 |
| 中文关键词: C-反应蛋白 降钙素原 血小板 清蛋白 新生儿坏死性小肠结肠炎 |
| 英文关键词: C-reactive protein Procalcitonin Platelet Albumin Neonatal necrotizing enterocolitis |
| 基金项目:安徽省科技厅公益技术应用研究联动计划项目（项目编号：1704f0804018）；安徽省卫生计生适宜技术推广项目（项目编号：2016-RK01） |
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| 中文摘要: |
| 目的 分析C-反应蛋白（CRP）、降钙素原（PCT）、血小板（PLT）及清蛋白等血清标志物在需手术治疗的新生儿坏死性小肠结肠炎（NEC）中的变化情况及临床意义，从而为临床最佳手术时机的选择提供参考。方法 回顾性分析2015年6月至2019年6月在安徽医科大学第一附属医院新生儿科收治的67例确诊为NEC（Bell分期II以上）的患儿病例资料，根据是否经过手术治疗，分为手术组（n=26）与非手术组（n=41），对两组患儿保守治疗前和保守治疗后（24~48 h）外周静脉血的PCT、CRP、PLT、清蛋白水平进行对比分析。结果 保守治疗后，手术组与非手术组CRP、PCT水平均高于治疗前（P<0.05），手术组PLT、清蛋白水平均低于治疗前，差异均有统计学意义（P<0.05）；保守治疗后，手术组PCT、CRP水平高于非手术组（P<0.05），PLT水平低于非手术组，差异均有统计学意义（P<0.05）。保守治疗后的CRP、PCT水平对NEC外科手术具有预测价值，最佳临界值分别为27.685 mg/L、14.675 mg/L，灵敏度和特异度分别为84.6%、68.3%和73.1%、82.9%。结论 PCT、CRP等血清标志物对NEC最佳手术时机的选择具有指导价值，CRP、PCT水平明显升高、PLT及清蛋白水平明显较前降低提示NEC患儿可能需要手术。 |
| 英文摘要: |
| Objective To analyze the changes and clinical significance of serum markers such as c-reactive protein (CRP), procalcitonin (PCT), platelet (PLT) and albumin in neonatal necrotizing enterocolitis (NEC) requiring surgical treatment, so as to provide a reference for the selection of optimal surgical time. Methods Retrospective analysis was performed on 67 cases of children diagnosed with NEC (Bell stage II or above) admitted to the Department of Neonatology of the First Affiliated Hospital of Anhui Medical University from June 2015 to June 2019. According to whether they were treated by surgery, the patients were divided into operation group (n=26) and non-surgery group (n=41).The levels of PCT, CRP, PLT and albumin in peripheral venous blood of the two groups before and after conservative treatment (24 h-48 h) were compared. Results After conservative treatment, the levels of CRP and PCT in surgery group and non-surgery group were higher than those before treatment (P<0.05), and the levels of PLT and albumin in surgery group were lower than before treatment (P<0.05). After conservative treatment, PCT and CRP levels in surgery group were higher than those in non-surgery group (P<0.05), and PLT levels were lower than those in non-surgery group (P<0.05). The levels of CRP and PCT after conservative treatment (24 h-48 h) had predictive value for NEC surgery. The optimal critical value was 27.685 mg/L and 14.675 mg/L respectively. The sensitivity and specificity was 84.6%, 68.3% and 73.1%, 82.9% respectively. Conclusions Serum markers such as PCT and CRP are of guiding value in the selection of the optimal time for NEC surgery. A marked increase of CRP and PCT levels and a marked decrease of PLT and albumin levels indicate a need of surgery for children with NEC. |
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