Predictive value of PCT and sCD14-ST combined with intra-abdominal pressure for the timing of surgical intervention for neonatal necrotizing enterocolitis

HU Fude; ZOU Dajun; XU Xiaoqing

doi:10.3969/j.issn.1002-3429.2026.06.010

Abstract：Objective To analyze the predictive value of inflammatory factors combined with intra-abdominal pressure(IAP)for the timing of surgical intervention for neonatal necrotizing enterocolitis(NEC).Methods A total of 60 neonates with NEC admitted to A from January 2020 to December 2024 were selected as the study subjects.Inflammatory factors and IAP were measured within 24 h after confirmed diagnosis of NEC.According to whether the neonates had surgical indications during hospitalization and underwent surgery or not,they were divided into the surgical group(n=32)and the non-surgical group(n=28).Inflammatory factors and IAP of the two groups were compared,and their predictive value for the timing of surgery for NEC was analyzed.Results The levels of C-reactive protein(CRP),procalcitonin(PCT),and soluble CD14 subtype(sCD14-ST)in the surgical group were higher than those in the non-surgical group(P<0.01).IAP of the surgical group was higher than that of the non-surgical group(P<0.01).Multivariate logistic regression analysis showed that PCT(OR=2.542,95%CI:1.243-5.199),sCD14-ST(OR=1.548,95%CI:1.058-2.264)and IAP(OR=1.201,95%CI:1.023-1.410)were independent factors affecting the timing of surgery(P<0.05).ROC analysis showed that the areas under the ROC curve(AUC)of PCT,sCD14-ST,and IAP for predicting the timing of surgery in neonates with NEC were 0.886(0.778,0.954),0.884(0.775,0.952),and 0.931(0.835,0.980),respectively,with no significant differences in pairwise comparisons among the three groups(P>0.05).The AUC of joint prediction using the three indicators was 0.990(0.922-1.000),significantly larger than that of PCT,sCD14-ST,or IAP alone(Z=2.404,2.486,2.183,respectively,P<0.05).Conclusion Inflammatory factors PCT,sCD14-ST,and IAP all exhibit certain predictive value for the timing of surgery in neonates with NEC,and combined detection of the three demonstrates higher predictive value.