Clinical Analysis Of Early-onset Neonatal Necrotizing Enterocolitis In Term Infants And Study Of Its Clinical Diagnostic Value By I-FABP

Objective: By comparing the difference between full-term infants with early-onset neonatal necrotizing enterocolitis(NEC)and early-onset sepsis,we evaluated the clinical value of intestinal fatty acid-binding protein(I-FABP)in full-term infants with early-onset necrotizing enterocolitis.so as to find a new basis for the early diagnosis of neonatal NEC,in order to achieve early detection,early diagnosis,early treatment,to reduce NEC mortality,improve prognosis.Methods: All infants enrolled in this study were recruited from the Neonatal Intensive Care Unit(NICU)of the Jining NO.1 People’s Hospital from february2014 to December 2017.Forty one cases of full-term infants with early-onset neonatal necrotizing enterocolitis and complete clinical data were chosen for the NEC group,including 17 newborns with NEC stage IB and 24 newborns with NEC stage II-III,while 62 patients with early-onset sepsis who were hospitalized during the same period were chosen as the control group.At the same time,venous blood was collected from two groups of newborns to detect plasma I-FABP level which was measured by enzyme-linked immunosorbent assay(ELISA).The diagnostic value of I-FABP for NEC was assessed using the receiver operating characteristic(ROC)curve.Simultaneous monitoring of serum CRP levels in the two groups of the newborn infants,compared the significance of this indicator for the diagnosis of NEC.Results: Asphyxia,infection,congenital heart disease and congenital bowel malformation were high risk factors for full-term infants with early-onset NEC,and the difference between the two groups was statistically significant(P<0.05).There was a significant difference between the two groups in breast-feeding(P<0.05).Gastrointestinal specific symptoms are more common in the NEC group,and the difference was statistically significant(P <0.05).There was no significant difference in serum CRP level between the case NEC Stage I and control groups(P>0.05).The serum levels of I-FABP in neonates of all stages of NEC group were significantly higher than those in control group(P<0.05),and the serum levels of I-FABP is significantly higher in stage II-III than those in stage IB(P<0.05);The area under the ROC curve for serum I-FABP was 0.84(95%CI: 0.78-0.92),with the optimal cut-off point of 2.24 ng/m L,and the specificity for diagnosis of NEC under the cut-off point was 70.18% and sensitivity was 80.47%.There was no significant difference in leukocyte count,CRP level,and platelet count between newborns in stage IB of NEC group and control group(P>0.05),but there was significant difference between the case stage II-III and control groups(P<0.05).Conclusions: Asphyxia,infection,congenital heart disease,and congenital bowel malformation are risk factors for full-term infants with early-onset necrotizing enterocolitis(NEC),and breastfeeding is a protective factor for NEC.There are significant differences in gastrointestinal symptoms between two groups.Serum levels of I-FABP are significantly elevated in full-term infants with early-onset NEC,and positively correlated with the severity of the disease,so serum I-FABP could be used as a reference index for neonatal NEC diagnosis.