الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 158 |  |  |
| | | from | 158 | | |
Abstract
SUMMARY UMMARYUMMARYUMMARYUMMARY
Necrotizing enterocolitis [NEC] is one of the commonestcauses of morbidity and mortality in VLBW preterm neonates world wide. NEC can be considered as the most serious catastrophicgastrointestinal emergency in the neonatal period.
The aim of our study is to evaluate the role of plasma citrulline level as a predictive marker of developing NEC in preterm neonates.
It was carried out in the NICU of Al mataria teaching hospital on fourty preterm neonates with a gestational age less than 37 weeks. The patients under the study were divided to two groups:
I- Cases (study group): consists of twenty preterm neonates who developed NEC during their admission period and were classified and diagnosed accordingto the Bell’s Staging of NEC.
II- Controls (control group): consists of twenty preterm neonates of matching birth weight and gestational age who were admitted in the NICU and did not develop manifestations of NEC during the admission period.
All neonates with inborn Errors of metabolism, congenital anomalies, surgical disorder, kidney, liver, or intestinal diseases
Summary
104
or had exchange transfusion during the period of blood sampling were excluded.
Allinfants under our study were subjected to:
i- Full history taking and careful physical examination
ii- Serial abdominal plainX-Ray films.
iii- Complete blood count, C- Reactive protein measurements.
iv- Plasma citrulline levels estimation byELISA Kits.
Blood sampling
Blood sampling was performed for all neonates under the study at birth and measurement of plasma citrulline level by ELISA was done and recorded as (citrulline D1). The second sample was drawn in day 10 of life and plasma citrulline level was recorded as (citrulline D10) for both groups.
Our study results showed the following:
No significant statistical difference were found between both groups as regarding age, birth weights, gender, mode of delivery and APGAR score.
According to laboratory results, nosignificant statistical difference were found between both groups as regarding hemoglobin level, total leucocytic count and a significantstatistical difference as regarding platelets count and CRP at day 10.
Summary
105
Regarding radiological findings, intestinal dilatation was seen in 15% of neonates, and repeated X-rays showed dilated fixed loops in 70% of cases with significant statistical difference between both groups and negative correlation between x-ray findings and NEC stages.
Our study showed a Significant negative correlation between Citrulline levels and radiological findings (p<0.01).
Our study showed that there is significant statistical difference of plasma Citrulline levels between both groups at day 10 with no significant statistical difference at day 1.
Our study showed Significant positive correlation between birth weight and gestational age andplasma citrulline levels.
Also our study showed Significant positive correlation between plasma Citrulline levels and stages of NEC.
Also we found significant increase of plasma Citrulline levels with increased post natal age of the controls from day 1 to day 10 with a P-value <0.01. This indicates improvement of intestinal functions, while in the cases plasma citrulline levelsdid not show the same increase and mostly decreased with the progression of NEC