Chornopyshchuk N. Clinical and Diagnostic Features of Necrotizing Enterocolitis of Prematurely Born Іnfants

The dissertation is devoted to the study of increasing the effectiveness of the diagnosis of necrotizing enterocolitis (NEC) in premature infants by determining the content of the intestinal fatty acid-binding protein (I-FABP), and identifying the risk factors of the onset and the lethal effect of NEC. Study design was developed based on the goals and objectives using a systematic approach and a set of clinical, immunological, biochemical, bacteriological, histological and instrumental studies. The study involved 70 premature infants with NEC and 25 infants without NEC who formed a control group, and 25 infants with NEC who died. Depending on the severity of NEC, the children of the main group were divided into three groups. The I group included 27 infants with NEC of the first stage, in the II group - 35 infants with NEC of the second stage, in the third group - 8 infants with NEC of the third stage. Infants of the III and II groups had a significantly lower gestational age at birth than infants of the control group (p<0.05). The average body weight at birth in infants of the III group was significantly lower (908.6±73.7) g than in the control group (1368.8±55.9 g) and in infants from groups I and II (1277.8±77.1) g and (1180.6±66.0) g respectively (p<0.05).The establishment of certain differences in the histological examination of the gut wall in prematurely born infants with different stages of the NEC, depending on the cause of the disease - infection or hypoxia. The presence of lymphohistiocytic infiltration of the submucosal membrane suggests postponed perinatal hypoxia and its leading role in the tanatogenesis of the disease, while polymorphic-cell segmental neutrophil infiltration is associated with perinatal infection.