患有死角性肠球炎的婴儿急性损伤:一个病例控制研究
Dermot Wildes1,2,3, Brian Patrick Cleary4, Ciara Terry5,4
1Department of Paediatrics, RCSI University of Medicine & Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland. dermotwildes@rcsi.com.
European journal of pediatrics
|October 14, 2025
概括
死亡性肠球炎 (NEC) 显著增加了早产婴儿急性损伤 (AKI) 的风险. 在NEC患者中,早期功能监测可以改善结果,并告知风险分层.
科学领域:
- 新生儿科学 新生儿科学
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
背景情况:
- 死性肠球炎 (NEC) 是早产婴儿疾病和死亡的主要原因,经常导致全身炎症和多器官功能障碍.
- 急性损伤 (AKI) 是新生儿的常见并发症,与不良结果有关,但其与NEC的特定关联需要进一步阐明.
研究的目的:
- 确定在被诊断为NEC的早产婴儿中AKI的发病率.
- 通过贝尔分期,调查NEC严重程度与AKI发生之间的关系.
- 评估NEC和AKI风险之间的关联,控制相关的临床因素.
主要方法:
- 一项回顾性病例控制研究将49名早产婴儿与NEC与100名对照 (1:2比) 根据出生体重,妊娠年龄和性别进行了匹配.
- 使用修改的新生儿KDIGO标准诊断AKI,同时考虑血清肌素和尿液输出.
- 在2018年10月至2023年10月期间,从单一的三级新生儿重症监护室 (NICU) 收集了数据.
主要成果:
- 在患有NEC的婴儿中,AKI的发病率为30.6%,而对照组为10%,在队列中,AKI的总发病率为16.8%.
- 尼克暴露独立地与AKI的3.6倍增加的几率相关 (aOR 3.6;95% CI 1.3-10.2;p=0.0129),即使在调整了PDA,出生体重,健美素和布洛芬之后.
- 死亡率在NEC-AKI组 (60%) 与没有AKI的NEC婴儿 (20.6%) 相比显著更高.
结论:
- 在早产婴儿中,NEC是AKI的重要风险因素,独立于其他临床变量.
- 虽然贝尔阶段在这个队列中与AKI发病率没有相关性,但研究结果强调了监测功能的重要性.
- 建议对患有NEC的婴儿进行早期功能监测,以帮助风险分层并可能改善临床结果.
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