Application of fecal calprotectin in diagnosing necrotizing enterocolitis of very low birth weight infants

Abstract

Objective To explore the diagnostic value of neutrophil-derived fecal marker fecal calprotectin (FC) in diagnosing necrotizing enterocolitis (NEC) for very low birth weight (VLBW) infants. Methods A total of 35 cases of VLBW infants with NEC symptoms who were gathered from Changzhou Children's Hospital and Changzhou Maternal and Child Health Care Hospital between July 2011 to June 2013 were selected as NEC group. NEC group were further divided into diagnosed NEC sub-group (n=15) and suspected NEC sub-group (n=20). Meanwhile, 30 VLBW infants with feeding intolerance were selected into feeding intolerance group (n=30), and 30 VLBW infants with normal milk-feeding and no gastrointestinal symptoms were selected into control group(n=30). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Changzhou Children's Hospital and Changzhou Maternal and Child Health Care Hospital. Informed consent was obtained from the parents of each participating child. The FC levels and occult blood (OB) were detected among different groups. And the FC levels and positive detection rates of OB among 4 groups were compared. Results The FC levels in the early stage and critical stage of diagnosed NEC sub-group were higher than that of control group (t=6.62, 8.44; P 0.05). Furthermore, there was significant difference in the aspect of positive detection rate of OB between critical stage in diagnosed NEC sub-group and control group (χ2=15.469, P 0.05). But there were no significant differences between suspected stage in suspected NEC sub-group and control group, recovery stage in suspected NEC sub-group and control group, feeding intolerance group and control group (χ2=2.000, 0.000, 0.185; P>0.05). Conclusions Compared with fecal OB test, the examination of FC was more sensitive in diagnosing early-stage NEC. FC level can be considered as an effective index to diagnose and evaluate VLBW infants combined with NEC. It can also be used to distinguish NEC and feeding intolerance. Key words: Infant, very low birth weight; Enterocolitis, necrotizing; Fecal calprotectin; Infant, newborn