Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis:: a placebo-controlled pilot study
Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis:: a placebo-controlled pilot study
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DOI：
10.1016/j.jpedsurg.2006.02.003
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发表时间：
2006-06-01
影响因子：
2.4
通讯作者：
Tekinalp, Gulsevin
中科院分区：
文献类型：
--
作者：
Canpolat, Fuat Emre;Yurdakok, Murat;Tekinalp, Gulsevin
背景/目的：人乳中粒细胞集落刺激因子（G-CSF）的存在以及新生儿肠绒毛肠细胞中G-CSF受体的表达提示G-CSF在胃肠道的发育和完整中起作用。我们假设，在早期给患有坏死性小肠结肠炎（NEC）的早产儿肠内注射重组人G-CSF （rhG-CSF）可以防止疾病进展和并发症。方法：轻度（1期）NEC的早产儿（n = 18）从诊断的第一天开始接受5天的rhG-CSF （n = 8）或安慰剂（n = 10）治疗。在整个住院期间，我们跟踪了临床和胃肠参数。结果：在研究组中，没有一例I期NEC婴儿临床进展到II期或III期，而在对照组中，5例（50%）I期NEC婴儿疾病进展到II期或III期（P < 0.05）。研究组NEC临床及影像学表现的消退时间、全身治疗及住院总时间均显著短于对照组（P < 0.001）。结论：肠内rhG-CSF治疗可防止轻度（1期）NEC进一步发展，缩短疾病临床和放射学症状消退所需的时间。(c) 2006爱思唯尔公司版权所有。
Background/Purpose: The presence of granulocyte colony-stimulating factor (G-CSF) in human milk and the expression of G-CSF receptors on intestinal villous enterocytes of neonates suggest that G-CSF has a role in the development and integrity of the gastrointestinal tract. We hypothesized that enteral recombinant human G-CSF (rhG-CSF) given to preterm infants with necrotizing enterocolitis (NEC) in the earlier stages could protect against disease progression and complications.Methods: Preterm infants with mild (stage 1) NEC (n = 18) were assigned to receive enteral rhG-CSF (n = 8) or placebo (n = 10) for 5 days from the first day of the diagnosis. Clinical and gastrointestinal parameters we re followed during the whole period of hospitalization.Results: In the study group, none of the infants with stage I NEC had a clinical progression to stage II or III, whereas in the control group, 5 (50%) infants with stage I NEC had a disease progression to stage II or III (P < .05). In the study group, the time required for the resolution of clinical and radiological findings of NEC and the total duration of systemic therapy and hospitalization were significantly shorter than the control group (P < .001).Conclusion: Enteral rhG-CSF treatment could prevent the progression of mild (stage 1) NEC to further stages and decrease the time required for the resolution of clinical and radiological signs of the disease. (c) 2006 Elsevier Inc. All rights reserved.