| Objective The aim of the study was to investigate serum I-FABP and D-LAC levels in NEC newborns with various stages, to analyze the correlation between the two biomarkers and the NEC, to compare difference in the distribution of these two in NEC children patients and try to explore their values in early diagnosis and clinical staging of NEC.Methods Thirty-six neonates were chosen in the Neonatal Care Center and Pediatric Surgery Department of our hospital from May 2014 to June 2015,who diagnosed as NEC by comprehensive analysis combining clinical manifestations, laboratory tests and imaging examination results according to the revised BELL staging criteria for diagnosis. According to the final diagnosis results, they were finally divided into the early stage NEC group(NEC ? n=17)and later stage NEC group(NEC ? n=7, NEC ? n=12). Thirty-six non-NEC infants with the same gestational age, birth weight, age and gender were chosen randomly and recruited as the control group. Routine blood test, C- reactive protein test, blood biochemistry analysis and fecal occult blood assay were conducted in each case when appeared suspicious NEC symptoms after admission within 24 hours. Serum samples for I-FABP and D-LAC determination were collected and stored at-80 ?in the refrigerator before analyzed.Results1. There was no distinctive difference among the three groups of children patients in birth weight, gestational age, blood age and gender composition ratio(p >0.05).2. There was statistical significance(p <0.05)in the group differences in white blood cell count, C- reactive protein and fecal occult blood results among the three groups of children patients. Nevertheless, no statistical significance was found in comparing the early stage NEC group with the control group, and the later stage NEC group with the early stage NEC group. Similarly no statistical significance in the group differences in platelet count, lactate dehydrogenase and creatine kinase was observed among the three groups of children patients.3.Serum I-FABP concentrations were(1.66±0.95)ng/ml,(3.99±4.03)ng/ml,(17.28±3.88)ng/ml respectively; serum D-LAC concentrations were(3.38±1.91)?g/ml,(6.63±4.29)?g/ml,(34.78±12.53)?g/ml among the three groups of children patients. Compared with the control group, both of the serum I-FABP and D-LAC concentrations in the early stage of NEC group and the later stage of NEC group increased significantly. Compared with the early stage NEC group,serum I-FABP and D-LAC concentrations of the later stage NEC group increased significantlyl. The results indicated that serum I-FABP and D-LAC concentrations increased in the early stage of NEC and further increased with the development of the disease to the later stage.4. In the case of 2.327 ng/ml as the cutoff value of I-FABP, the sensitivity to NEC diagnosis was 0.861,specificity was 0.806,accuracy(Youden Index)was 0.667,positive predictive value was 0.816,and negative predictive value was 0.853. In the case of 6.172?g/ml as the cutoff value of D-LAC, the sensitivity to NEC diagnosis was 0.778, specificity was 0.861, accuracy(Youden Index)was 0.639, positive predictive value was 0.848, and negative predictive value was 0.795.5. Combining I-FABP with D-LAC, the sensitivity of NEC diagnosis increased to0.917 by parallel testing. When they were tested simultaneously, the diagnostic efficiency of NEC would be improved.Conclusions1. WBC, CRP and fecal occult blood test in NEC cases were correlated with the patients' symptoms certainly, but they were not suitable for early diagnosis of NEC.Serum indexes including PLT, LDH and CK were poorly correlated with the symptoms of children patients, which were affected by many factors.2. Serum I-FABP and D-LAC concentrations reflected the clinical symptoms of children patients and increased with the development of the disease.3. The early diagnostic efficiency of NEC can be improved by use of combining I-FABP and D-LAC assays with parallel testing. |
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