目的 探讨内皮糖萼损伤标志物多配体蛋白聚糖⁃1（syndecan⁃1, SDC⁃1）对早产儿坏死性小肠结肠炎（necrotizing enterocolitis, NEC）的临床诊断价值。 方法 采用多中心、前瞻性研究设计，选取2025年2—7月陆军军医大学第一附属医院、四川省妇幼保健院及聊城市人民医院住院的Bell分期Ⅱ~Ⅲ期NEC早产儿为NEC组（38例），按1∶1比例选择同期非NEC早产儿为非NEC组（38例）。收集两组患儿围产期资料以及血常规、SDC⁃1及超敏C反应蛋白（high-sensitivity C⁃reactive protein，hs⁃CRP）等指标的检测结果，采用多因素logistic回归分析评估早产儿NEC发生的危险因素，通过受试者操作特征曲线评估SDC⁃1对NEC的诊断价值。 结果 NEC组中性粒细胞计数、SDC⁃1及hs⁃CRP水平显著高于非NEC组患儿（P<0.05），血小板计数显著低于非NEC组患儿（P<0.05）。多因素logistic回归分析显示，SDC⁃1（OR=1.081，95%CI：1.028~1.137，P<0.05）及hs⁃CRP（OR=1.267，95%CI：1.051~1.527，P<0.05）水平升高是早产儿NEC发生的独立危险因素。受试者操作特征曲线分析显示，SDC⁃1（临界值为125 ng/mL）及hs⁃CRP（临界值为6.56 mg/L）诊断早产儿NEC的曲线下面积分别为0.882、0.863，两者联合对早产儿NEC诊断的曲线下面积为0.938，灵敏度和特异度分别为76.3%、97.4%。 结论 SDC⁃1可作为诊断早产儿NEC的潜在生化标志物，但其临床应用价值仍需更大样本研究进一步验证。

Objective To investigate the clinical diagnostic value of the endothelial glycocalyx injury biomarker syndecan-1 (SDC-1) for necrotizing enterocolitis (NEC) in preterm infants. Methods A multicenter, prospective study was conducted from February to July 2025 at the First Affiliated Hospital of Army Medical University, Sichuan Maternal and Child Health Hospital, and Liaocheng People's Hospital. Preterm infants with Bell stage Ⅱ-Ⅲ NEC were enrolled as the NEC group (n=38), and contemporaneous non-NEC preterm infants were selected in a 1∶1 ratio as the non-NEC group (n=38). Perinatal data and measurements of complete blood counts, SDC-1, and high-sensitivity C-reactive protein (hs-CRP) were collected. Multivariable logistic regression was used to evaluate risk factors for NEC. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance of SDC-1. Results Neutrophil count, SDC-1, and hs-CRP levels were significantly higher in the NEC group than in the non-NEC group (P<0.05), while platelet count was significantly lower (P<0.05). Elevated SDC-1 (OR=1.081, 95%CI: 1.028-1.137; P<0.05) and hs-CRP (OR=1.267, 95%CI: 1.051-1.527; P<0.05) were independent risk factors for NEC. ROC analysis showed that SDC-1 (cutoff 125 ng/mL) and hs-CRP (cutoff 6.56 mg/L) yielded areas under the curve (AUCs) of 0.882 and 0.863, respectively. Their combination achieved an AUC of 0.938 with a sensitivity of 76.3% and a specificity of 97.4%. Conclusions SDC-1 is a potential biochemical biomarker for diagnosing NEC in preterm infants, but its clinical utility requires further validation in larger-sample studies.