多配体蛋白聚糖-1对早产儿坏死性小肠结肠炎的诊断价值:一项多中心前瞻性研究OA

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.