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目的探索粪钙卫蛋白(FC)水平在早期诊断早产儿坏死性小肠结肠炎(NEC)中的临床价值。方法选择入住福建省妇幼保健院新生儿科的76例怀疑发生NEC的早产儿为观察组,依据修正的BELL-NEC分期标准,根据最后诊断结果分为病例组和喂养不耐受组,并选取同期住院的38例喂养顺利的早产儿作为对照组。病例组及喂养不耐受组患儿在出现症状的24h、48h内及恢复期,对照组与病例组出生后相同日龄,从患儿尿布中采集粪便标本测定FC水平。结果病例组24h、48h的FC水平均高于喂养不耐受组和对照组;恢复期病例组FC水平较发病时24h和48h的FC水平明显下降;FC以57.95pg/mL为临界值时,敏感性89.5%,特异性79.0%;FC水平与NEC的严重程度(临床分期)呈正相关。结论 FC有望作为早产儿NEC早期诊断、预测病情严重性及治疗效果的一项有价值的无创性生化指标。
Objective To explore the clinical value of fecal calprotectin (FC) in the early diagnosis of necrotizing enterocolitis (NEC) in preterm infants. Methods According to the modified BELL-NEC staging criteria, 76 preterm infants with suspected NEC in the neonatology department of MCH hospital of Fujian Province were divided into case group and infertile group according to the final diagnosis results. 38 hospitalized patients were fed a smooth preterm children as a control group. In the case group and the group fed the intolerant group, the faecal samples were collected from the diaper of the children at the same age of birth as the control group and the case group at 24 h, 48 h after the onset of symptoms, and the FC level was measured. Results The levels of FC in 24h and 48h were significantly higher in case group than those in non-tolerated group and control group. The levels of FC in convalescent group were significantly lower than those in control group at 24h and 48h. When FC was 57.95pg / mL, Sensitivity 89.5%, specificity 79.0%; FC level and the severity of NEC (clinical stage) was positively correlated. Conclusions FC is expected to be a valuable noninvasive biochemical marker for the early diagnosis of NEC in preterm infants and the prediction of the severity of the disease and the therapeutic effect.