rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2023-2-2304rmt-2319Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESИнтер-альфа ингибиторные белки как предиктор некротизирующего энтероколита у новорожденныхInter-Alpha Inhibitor Proteins as a Predictor of Necrotizing Enterocolitis in Newborn Infantshttps://orcid.org/0000-0002-4853-4648ЭльменезаС. А.ELMenezaS. A.

Медицинский факультет.

11751, Каир, Наср, ул. Юссефа Аббаса, 383C+QMC

Safaa A. ELMeneza – professor of pediatrics and neonatology, Faculty of Medicine for Girls.

383C+QMC Youssef Abbas Str., Nasr city, 11751 Cairo

safaa5@hotmail.comАрафатН. М.ArafatN. M.

Медицинский факультет.

11751, Каир, Наср, ул. Юссефа Аббаса, 383C+QMC

Neveen M. Arafat – Faculty of Medicine for Girls.

383C+QMC Youssef Abbas Str., Nasr city, 11751 Cairo

neveen.mohammed123@gmail.comhttps://orcid.org/0000-0002-9001-7994Эль-БагуриИ. М.El-BagouryI. M.

Медицинский факультет.

11751, Каир, Наср, ул. Юссефа Аббаса, 383C+QMC

Iman M. El-Bagoury – Professor of Clinical pathology department, Clinical pathology department, Faculty of Medicine for Girls.

383C+QMC Youssef Abbas Str., Nasr city, 11751 Cairo

imanelbagoury@hotmail.comГаберА.GaberA.

Медицинский факультет.

11751, Каир, Наср, ул. Юссефа Аббаса, 383C+QMC

Amal Gaber - Professor pediatrics, Faculty of Medicine for Girls.

383C+QMC Youssef Abbas Str., Nasr city, 11751 Cairo

amalgaber036@gmail.comУниверситет Аль-АзхарЕгипетAL-Azhar UniversityEgypt2023250420231923339Copyright © Эльменеза С.А., Арафат Н.М., Эль-Багури И.М., Габер А., 20232023Эльменеза С.А., Арафат Н.М., Эль-Багури И.М., Габер А.ELMeneza S.A., Arafat N.M., El-Bagoury I.M., Gaber A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/2319

Некротизирующий энтероколит (НЭК) — острое заболевание многофакторного генеза с неблагоприятным прогнозом. Интер-альфа ингибиторный белок относится к ингибиторам сериновых протеаз, которые участвуют во многих процессах в норме и патологии.

Цель

Цель. Оценка роли интер-альфа ингибиторного белка в прогнозе и повышении точности диагностики НЭК у новорожденных с неспецифическими абдоминальными и кишечными проявлениями.

Материалы и методы

Материалы и методы. В проспективное, продольное исследование включили 80 новорожденных детей с неспецифическими абдоминальными симптомами, которых разделили на две группы. В группу А включили детей с НЭК II или III стадии в соответствии с модифицированными критериями Белла. В группу В вошли новорожденные без НЭК. Содержание интер-альфа ингибиторного белка в сыворотке определяли методом ИФА.

Результаты

Результаты. В группе с НЭК средняя концентрация интер-альфа ингибиторного белка составила 9,38 мг/л, что было значимо ниже, чем в группе без НЭК (44,40 мг/л). Содержание интер-альфа ингибиторного белка у новорожденных было ниже на стадии IA НЭК, чем на стадии IIIB (р<0,01). Его концентрация была снижена у недоношенных и доношенных новорожденных с чувствительностью 98% и специфичностью 96%, с точкой отсечения <19,42 и <19,96 мг/л, соответственно. Для пациентов с летальным исходом точка отсечения составила >13,29 мг/л, с чувствительностью 53,33% и специфичностью 92,31%.

Заключение

Заключение. Содержание интер-альфа ингибиторного белка снижается как у доношенных, так и у недоношенных новорожденных с НЭК, в связи с чем контроль этого показателя позволяет улучшить точность диагностики данного заболевания. Показатель ассоциирован с тяжестью заболевания и может применяться для прогноза летального исхода.

Necrotizing enterocolitis is a devastating emergency, multifactorial disease. Inter-alpha inhibitor proteins are serine protease inhibitors involved in many physiological and pathological activities.

Aim

Aim: this study was designed in order to assess the value of inter-alpha inhibitor proteins in predicting and improving accuracy of diagnosis of NEC in newborn infants with non-precise abdominal and intestinal manifestations.

Materials and Methods

Materials and Methods. This study was prospective longitudinal research that included 80 newborn infants presented with non-specific abdominal manifestations. Infants were divided into two groups. Group A; infants who developed necrotizing enterocolitis, they had stage II or III necrotizing enterocolitis according to modified Bell's criteria. Group B; included infants who did not develop necrotizing enterocolitis. Serum inter alpha inhibitor proteins level was measured by ELISA.

Results

Results. In necrotizing enterocolitis group, the median inter-alpha inhibitor protein level was (9.38 mg/L), this was significantly lower than non-necrotizing enterocolitis group (44.40 mg/L), P<0.01. Inter-alpha inhibitor protein was reduced in stage IA than stage IIIB. Inter-alpha inhibitor protein values were decreased in preterm and full term infants with sensitivity of 98 % and specificity of 96% at cutoff <19.42 and <19.96 mg/L. The cut off in non-survival cases was >13.29 mg/L with sensitivity of 53.33 % and specificity of 92.31%.

Conclusion

Conclusion. Inter-alpha inhibitor protein levels were reduced in full term and preterm infants with necrotizing enterocolitis, consequently it may improve diagnosis of necrotizing enterocolitis in newborn infants. It has prognostic value and correlate with severity of necrotizing enterocolitis. It might predict non-survival cases.

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The authors declare that there are no conflicts of interest present.