Abstract：Objective To study the changes in C-reactive protein (CRP) and procalcitonin (PCT) levels in neonates with necrotizing enterocolitis (NEC) and their clinical significance. Methods According to the modified Bell's staging criteria, 142 neonates with NEC were divided into stage I group (n=40), stage Ⅱ group (n=72), and stage Ⅲ group (n=30). All the 18 neonates who underwent surgical treatment had stage Ⅲ NEC, and among the 124 neonates who underwent conservative treatment, 12 had stage Ⅲ NEC and the others had stage I or Ⅱ NEC. CRP and PCT were measured before treatment, on the next day after treatment, and during the recovery stage. Results Before treatment, on the next day after treatment, and during the recovery stage, the stage Ⅲ group had a higher level of CRP than the stage I and stage Ⅱ groups (P < 0.05). On the next day after treatment, the stage Ⅱ and stage Ⅲ groups had an increase in CRP (P < 0.05), and the stage Ⅲ group had an increase in PCT (P < 0.05). The stage Ⅱ and stage Ⅲ groups had lower CRP and PCT in the recovery stage than before treatment and on the next day after treatment (P < 0.05). The stage Ⅲ group had higher incidence rate of respiratory failure and rate of mechanical ventilation than the stage I and stage Ⅱ groups (P < 0.05), and the stage Ⅲ group had a higher incidence rate of sepsis than the stage Ⅱ group (P=0.010). Gastrointestinal perforation and intestinal stenosis were observed in 10 and 8 neonates respectively in the stage Ⅲ group. CRP on the next day after treatment had a value in predicting stage Ⅲ NEC (P < 0.05), and CRP before treatment and on the next day after treatment had a value in predicting the need for surgery (P < 0.05). Conclusions Levels of CRP and PCT and their changes can help with the early diagnosis of Bell stage Ⅱ/Ⅲ NEC, and CRP can be used to predict the development of stage Ⅲ NEC and the need for surgery.
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