| 苗耐英,李欢,张婕,等.血清几丁质酶 3样蛋白 1、闭锁小带蛋白 -1表达对新生儿坏死性小肠结肠炎病儿革兰阴性菌感染的诊断价值[J].安徽医药,2026,30(1):102-106. |
| 血清几丁质酶 3样蛋白 1、闭锁小带蛋白 -1表达对新生儿坏死性小肠结肠炎病儿革兰阴性菌感染的诊断价值 |
| Diagnostic value of serum chitinase 3-like protein 1 and zonula occludens-1 expression in neonates with necrotizing enterocolitis complicated by gram-negative bacterial infection |
| |
| DOI：10.3969/j.issn.1009-6469.2026.01.021 |
| 中文关键词: 小肠结肠炎，坏死性 革兰阴性菌感染 几丁质酶 3样蛋白 1 闭锁小带蛋白 -1 C反应蛋白 婴儿，新生 |
| 英文关键词: Enterocolitis,necrotizing Gram-negative bacterial infections Chitinase-3-like protein-1 Zonula occluden-1 C-re-active protein Infant,newborn |
| 基金项目: |
|
| 摘要点击次数: 494 |
| 全文下载次数: 943 |
| 中文摘要: |
| 目的探究血清几丁质酶 3样蛋白 1(YKL-40)、闭锁小带蛋白 -1(ZO-1)表达对新生儿坏死性小肠结肠炎( NEC)病儿革兰阴性菌感染的诊断价值。方法选取 2022年 9月至 2023年 9月在河北中石油中心医院进行诊治的 60例 NEC病儿作为 NEC组，选取同时期在该院出生的 60例健康新生儿作为健康组，酶联免疫吸附分析( ELISA)检测血清中 YKL-40、ZO-1、C反应蛋白(CRP)水平。根据贝尔(Bell)分期将 NEC病儿分为 Ⅰ期组(36例)Ⅱ+Ⅲ期组(24例)； Pearson法分析 NEC组病儿血清中 YKL-40、ZO-1水平与 CRP水平之间的相关性。受试者操作特征曲线(ROC曲、线)分析血清 YKL-40、ZO-1水平对 NEC病儿革兰阴性菌感染的诊断价值。结果与健康组比较， NEC组病儿血清中 YKL-40、CRP水平升高， ZO-1水平降低( P<0.05)；与Ⅰ期组比较， Ⅱ+ Ⅲ期组病儿血清中 YKL-40、CRP水平升高， ZO-1水平降低( P<0.05)； 60例 NEC病儿的粪便中共培养出 68株病原菌，其中革兰阴性菌 51株，占比 75.00 %；革兰阳性菌 17株，占比 25.00%。Ⅰ期、 Ⅱ+Ⅲ期病儿的粪便中病原菌均以革兰阴性菌为主，其中革兰阴性菌以大肠埃希菌为主，差异有统计学意义( χ2=4.42，P=0.036)；与革兰阳性菌组比较，革兰阴性菌组病儿血清中 YKL-40、 CRP水平升高， ZO-1水平降低( P<0.05)； Pearson分析显示， NEC病儿血清 YKL-40水平与 CRP水平呈正相关( r=0.56，P<0.001)， NEC病儿血清 ZO-1水平与 CRP水平呈负相关( r=.0.51，P<0.001)。 ROC曲线显示，血清 YKL-40、ZO-1两者联合诊断 NEC病儿革兰阴性菌感染的 AUC显著大于 YKL-40单独诊断的 AUC(Z=2.22，P=0.026)。结论 NEC病儿病原菌分布主要以革兰阴性菌为主，病儿血清中 YKL-40水平较高， ZO-1水平较低，与病原菌分布有关，同时检测 YKL-40、ZO-1可提高对 NEC病儿革兰阴性菌感染的诊断价值。 |
| 英文摘要: |
| Objective To explore the diagnostic value of serum chitinase 3-like protein-1 (YKL-40) and atretic zonulin-1 (ZO-1) ex-pression in gram-negative bacteria infection associated with neonatal necrotizing enterocolitis (NEC). Methods Sixty children withNEC who were diagnosed and treated in Hebei Petro China Central Hospital from September 2022 to September 2023 were collected asthe NEC group, and 60 healthy newborns born at the same time in the same hospital were regarded as the健康组 . Enzyme linked immu-nosorbent assay (ELISA) was applied to detect the levels of YKL-40, ZO-1,and C-reactive protein (CRP) in serum. According to Bell's staging, NEC patients were assigned to stageⅠgroup (n=36) or stage Ⅱ+Ⅲ group (n=24). Pearson method was applied to analyze the cor-relation between serum YKL-40, ZO-1 levels and CRP level in children with NEC. The diagnostic value of serum YKL-40 and ZO-1 lev-els in the diagnosis of Gram negative bacterial infections in children with NEC was evaluated using receiver operating characteristiccurve (ROC curve) analysis. Results Compared with the health group, the serum levels of YKL-40 and CRP in the NEC group in-creased, while the level of ZO-1 decreased (P<0.05); compared with the stageⅠgroup, the serum levels of YKL-40 and CRP in the stage Ⅱ+Ⅲ group increased, while the level of ZO-1 decreased (P<0.05). A total of 68 pathogenic bacteria were cultured in the feces of 60children with NEC, of which 51 (75.00%) were Gram negative bacteria, and 17 (25%) Gram positive bacteria. The pathogenic bacteria inthe feces of stageⅠchildren, stageⅡ+Ⅲ children were mainly Gram negative bacteria, among which Escherichia coli was the main Gram negative bacterium, with a statistically significant difference (χ2=4.42, P=0.036). Compared with the Gram positive bacterial group, the serum levels of YKL-40 and CRP in the Gram negative bacterial group increased, while the level of ZO-1 decreased (P<0.05); Pearson analysis results showed that serum YKL-40 level was positively correlated with CRP level in NEC patients (r=0.56, P<0.001), while se-rum ZO-1 level was negatively correlated with CRP level in NEC patients (r=.0.51, P<0.001). ROC curve showed that the AUC of serum YKL-40 combined with ZO-1 in the diagnosis of Gram negative bacterial infection in NEC children was obviously higher than that of YKL-40 alone (Z=2.22, P=0.026).Conclusions The predominant pathogens in neonates with NEC are Gram negative bacteria. Neo-nates with NEC have higher serum YKL-40 levels and lower ZO-1 levels, which are related to the distribution of pathogenic bacteria. Si-multaneous detection of YKL-40 and ZO-1 can improve the diagnostic value for Gram negative bacterial infections in NEC children. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
