Non-intervention observation: Dynamic evolution laws of inflammatory response in necrotizing enterocolitis

摘要

The pathogenesis of necrotizing enterocolitis (NEC) is not well understood but immunological factors are thought to be key determinants of the disease appearance and its prognosis. During the course of the present study, different groups of newborn infants were observed and tested, to obtain an accurate image of values of pro- and anti-inflammatory cytokines at the onset, development and progression of neonatal NEC and to compare the values to those obtained during normal healthy development. All the infants in the study received standard medical treatment as appropriate. Initially, all the low birth weight premature infants born between June, 2014 and June, 2015 were tested on days 1, 3, 7, 10, 14, and 21 after birth, to obtain serum values of platelet activating factor (PAF), interleukin-1 (IL-1), tumor necrosis factor- (TNF-) and IL-10. In total, 150 low birth weight premature infants were included, and the incidence of NEC was 6.67% (10/150). For the comparison studies, 10 premature NEC infants of low birth weight, 15 premature normal infants, and 15 full-term normal infants born during the same period were enrolled in the study. The serum values of PAF, IL-1, TNF- and IL-10 for these infants were detected on the same days after birth. PAF, IL-1 and TNF- levels began to increase on days 1-3 after birth in premature infants, reached a peak on days 7-10, and declined to normal levels on days 14-21. Comparison differences in premature and full-term infants were statistically significant (P<0.01). Interleukin-10 began to increase on days 7-10 after birth in premature infants and reached a peak on days 14-21. Comparisons among premature and full-term infants at the given time points showed the differences were also statistically significant (P<0.01). The differences in values of the above inflammatory cytokines in the infants that died and the values in the survivors were not statistically significant (P>0.05). In conclusion, pro-inflammatory factors PAF, IL-1, TNF- and anti-inflammatory factor IL-10 may be important in the pathogenesis of NEC, and monitoring their levels in blood can be useful in the prediction of the occurrence of disease. Nevertheless, these levels are not useful as prognostic markers.