| 高丽艳,王晓林.早期超声筛查联合SAA、IL-6、CRP对早产儿NEC的早期预测价值[J].安徽医药,待发表. |
| 早期超声筛查联合SAA、IL-6、CRP对早产儿NEC的早期预测价值 |
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| 投稿时间：2026-07-07 录用日期：2026-08-21 |
| DOI： |
| 中文关键词: 早期超声筛查 血清淀粉样蛋白A 白细胞介素-6 C反应蛋白 早产儿 坏死性小肠结肠炎 |
| 英文关键词: |
| 基金项目:山西省卫生健康委员会科研项目(WJ2024H142) |
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| 中文摘要: |
| 目的：探讨早期超声筛查联合血清淀粉样蛋白A（SAA）、白细胞介素-6（IL-6）、C反应蛋白（CRP）对早产儿坏死性小肠结肠炎（NEC）的早期预测价值。方法：选取2021年1月-2025年1月于山西医科大学第二医院收治疑似NEC的119例单胎早产儿，根据其是否患有NEC分入NEC组（n=65）和非NEC组（n=54）。收集并比较两组一般资料、早期超声筛查结果、SAA、IL-6和CRP水平，采用Spearman相关分析法分析早期超声筛查、SAA、IL-6和CRP水平与早产儿NEC的相关性，采用多因素logistic回归模型分析早产儿NEC的影响因素，采用受试者工作特征（ROC）曲线评估早期超声筛查、SAA、IL-6和CRP水平联合检测及其单一指标检测对早产儿NEC的早期预测价值。结果：NEC组胎龄低于非NEC组（P＜0.05）；NEC组早期超声筛查阳性率高于非NEC组（P＜0.05）；NEC组SAA、IL-6和CRP水平高于非NEC组（P＜0.05）；超声筛查的OR值为10.020，95%CI为3.762-26.689，SAA的OR值为1.805，95%CI为1.171-2.782，IL-6的OR值为1.222，95%CI为1.073-1.393，CRP的OR值为1.093，95%CI为1.002-1.192；超声筛查为阳性、SAA水平、IL-6和CRP水平升高是早产儿NEC的危险因素（均P＜0.05）；超声筛查结果的曲线下面积（AUC）为0.761，95%CI为0.683-0.839，SAA的AUC为0.689，95%CI为0.592-0.786，IL-6的AUC为0.634，95%CI为0.532-0.735，CRP的AUC为0.671，95%CI为0.575-0.768，联合检测的AUC为0.885，95%CI为0.824-0.945。采用DeLong检验，联合检测AUC高于超声筛查结果（Z=-2.390，P=0.017），高于SAA（Z=-3.581，P＜0.001），高于IL-6（Z=-4.312，P＜0.001），高于CRP（Z=-3.470，P=0.001）。结论：早期超声为阳性、SAA、IL-6和CRP水平较高是早产儿NEC的危险因素；在本数据集中，相较于单一指标检测，早期超声筛查、SAA、IL-6和CRP水平联合检测具有更高的预测价值。 |
| 英文摘要: |
| Objective: To investigate predictive value of early ultrasound screening combined with serum amyloid A (SAA), interleukin-6 (IL-6), and C-reactive protein (CRP) for early diagnosis of necrotizing enterocolitis (NEC) in preterm infants. Methods: 119 singleton preterm infants with suspected NEC admitted to Second Hospital of Shanxi Medical University from January 2021 to January 2025 were selected, of which 65 were finally clinically diagnosed as having NEC and 54 were not, and were divided into NEC group (n=65) and non-NEC group (n=54) according to whether they had NEC or not. General information, early ultrasound screening results, SAA, IL-6 and CRP levels were collected and compared between two groups. Correlation of early ultrasound screening, SAA, IL-6 and CRP levels with NEC in preterm infants was analyzed using spearman correlation analysis. Influencing factors of NEC in preterm infants were analyzed using a multivariate logistic regression model. Early predictive value of early ultrasound screening, SAA, IL-6, and CRP levels in combined detection as well as their individual indicator detection for NEC in preterm infants was evaluated using the receiver operating characteristic (ROC) curve. Results: Gestational age was lower in NEC group than in non-NEC group (P<0.05); Positive rate of early ultrasound screening was higher in NEC group than in non-NEC group (P<0.05); SAA, IL-6 and CRP were higher in NEC group than in non-NEC group (P<0.05); Positive ultrasound screening, elevated levels of SAA, IL-6 and CRP were risk factors for NEC in premature infants (P<0.05); OR value of ultrasound screening was 10.020 (95%CI: 3.762?26.689); OR value of SAA was 1.805 (95%CI: 1.171?2.782); OR value of IL?6 was 1.222 (95%CI: 1.073?1.393); and OR value of CRP was 1.093 (95%CI: 1.002?1.192); Area under curve (AUC) for ultrasonographic screening was 0.761 (95%CI: 0.683?0.839). AUC of SAA was 0.689 (95%CI: 0.592?0.786), AUC of IL?6 was 0.634 (95%CI: 0.532?0.735), and AUC of CRP was 0.671 (95%CI: 0.575?0.768). AUC of combined detection reached 0.885 (95%CI: 0.824?0.945). DeLong test revealed that AUC of combined detection was higher than that of ultrasonographic screening (Z=?2.390, P=0.017), SAA (Z=?3.581, P<0.001), IL?6 (Z=?4.312, P<0.001), and CRP (Z=?3.470, P=0.001). Conclusion: Positive early ultrasound screening results and high levels of SAA, IL-6, and CRP are risk factors for NEC in preterm infants; Combined testing of early ultrasound screening, SAA, IL-6, and CRP levels has a higher predictive value compared with single-indicator testing. |
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