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目的:探讨血乳酸和肿瘤坏死因子-α(TNF-α)在早产儿坏死性小肠结肠炎(NEC)中的变化及临床意义。方法:选取Ⅱ~Ⅲ期NEC早产儿为NEC组,并根据临床评价分期,按1∶1比例选择同期非NEC早产儿为非NEC组,NEC组在确诊NEC后即刻采血,非NEC组选择相同时间点取血。分别测定血乳酸浓度和血浆TNF-α浓度。结果:NECⅡ期患儿血乳酸和TNF-α水平分别为(6.5±0.6)mmol/L和(33.8±4.8)ng/dl;NECⅢ期患儿血乳酸和TNF-α水平分别为(8.7±0.7)mmol/L和(39.1±2.6)ng/dl;非NEC组分别为(1.5±0.8)mmol/L和(18.3±5.6)ng/dl。NEC患儿血乳酸和TNF-α水平显著高于非NEC组,Ⅲ期患儿高于Ⅱ期患儿(P<0.05);血乳酸和TNF-α水平与NEC分期均呈正相关关系。结论:NEC患儿血乳酸和TNF-α浓度明显高于非NEC组,与临床分期基本一致,检测血乳酸与TNF-α水平,对于NEC早期诊断、判断病情进展及评价治疗效果有一定临床意义。
Objective: To investigate the changes and clinical significance of blood lactate and tumor necrosis factor-α (TNF-α) in neonatal necrotizing enterocolitis (NEC). Methods: The preterm infants with stage Ⅱ ~ Ⅲ NEC were selected as the NEC group. According to the clinical evaluation stage, non-NEC preterm infants of non-NEC group were selected as non-NEC group according to the ratio of 1:1. NEC group received the same blood sample immediately after the diagnosis of NEC. Take blood at a time. Blood lactate concentration and plasma TNF-α concentration were measured. Results The levels of blood lactic acid and TNF-α in children with NECⅡ were (6.5 ± 0.6) mmol / L and (33.8 ± 4.8) ng / dl, respectively. The levels of blood lactate and TNF-α in children with NECⅡ were (8.7 ± 0.7 ) (mmol / L) and (39.1 ± 2.6) ng / dl in non-NEC group and (1.5 ± 0.8) mmol / L and (18.3 ± 5.6) ng / dl in non- The levels of serum lactic acid and TNF-α in children with NEC were significantly higher than those in non-NEC and those in stage Ⅲ were higher than those in stage Ⅱ (P <0.05). The levels of serum lactate and TNF-α were positively correlated with the stage of NEC. Conclusion: The levels of blood lactic acid and TNF-α in children with NEC were significantly higher than those in non-NEC group. The levels of serum lactic acid and TNF-α in blood serum of patients with NEC were basically the same as those of non-NEC group. It had some clinical significance for NEC early diagnosis, judgment of disease progression and evaluation of treatment effect .