Changes Of Serum Markers In Neonates With Necrotizing Enterocolitis Requiring Surgical Treatment

Objective:The changes and clinical significance of serum markers such as c-reactive protein(CRP),procalcitonin(PCT),platelet(PLT)and albumin in neonates with necrotizing enterocolitis(NEC)requiring surgical treatment were analyzed,so as to provide guidance for the selection of optimal surgical timing.Methods:From June 2015 to June 2019,67 cases with NEC(bell stage II or above)diagnosed in neonatology department of the First Affiliated Hospital of Anhui Medical University were analyzed retrospectively.The clinical data of 67 cases included in this study were compared: sex,age,birth weight,age at onset,delivery mode,start feeding time and other clinical data.According to whether they have passed through the hand or not The operation group(n = 26)and the non operation group(n = 41).The PCT,CRP,PLT and albumin levels in the peripheral venous blood of the two groups before and after the conservative treatment(24-48 h)were compared and analyzed by using the parameter test(Mann Whitney U and Wilcoxon test),and the results were compared and analyzed(P <0.05)the specificity,sensitivity and Youden index of NEC diagnosis by ROC analysis.Results:After conservative treatment(24h-48h),the CRP level in the operation group and the non operation group was higher than that before treatment {55.42(32.44,88.73)and 22.44(14.75,35.73),0.68(0.50,11.08)and 1.190(0.50,4.56),and the Z value was-4.286,-4.140,respectively,P < 0.05};After conservative treatment(24h-48h),the PCT level in operation group and non operation group was higher than that before treatment {21.31(14.79,70.71)and 5.87(1.61,12.46),0.46(0.20,2.96)and 0.75(0.25,2.59),Z value was-3.945,-3.503,P value < 0.05 };After conservative treatment(24h-48h),PLT and albumin levels in operation group were lower than those before treatmen { 198.50(147.75257.25)and 27.40(25.30,31.00),273.00(199.00352.75)and 30.50(27.25,32.05),Z values were-3.486,2.345,P < 0.05}.After conservative treatment(24h-48h),the levels of CRP and PCT in the operation group were higher than those in the non operation group{55.42(32.44,88.73)and 21.31(14.79,70.71),22.44(14.75,35.73)and5.87(1.61,12.46),Z values were-4.160,-4.819,P values were less than 0.05};After conservative treatment(24h-48h),PLT level in the operation group was lower than that in the non operation group {198.50(147.75257.25),259.00(166.00328.50),Z value was-2.012,P value < 0.05}.The levels of CRP and PCT after conservative treatment(24h-48h)have predictive value for NEC;The optimal cut-off values were 27.685 mg / L and14.675 mg / L,respectively.The sensitivity and specificity were 84.6%,68.3% and73.1%,82.9% respectively.Conclusion:After conservative treatment(24h-48h),CRP and PCT levels were significantly increased,and PLT and albumin levels were significantly lower than before,indicating that children with NEC might need surgery.Serum markers such as PCT and CRP have guiding value in the selection of optimal timing of NEC surgery.