Article Text


281 Protein C and Protein S in the Diagnosis, Management and Prognosis of Premature Infant with Necrotizing Enterocolitis
  1. LS Wang1,
  2. GQ Cheng2,
  3. Y Cao2,
  4. XM Shao2,
  5. WH Zhou2
  1. 1Department of Neonatology
  2. 2Children’s Hospital, Fudan University, Shanghai, China


Objective In this prospective, observational study, we determined whether serum protein C and protein S (PC/PS) activity correlated with necrotizing enterocolitis (NEC) stages II and III in premature infant. We hypothesized that PC/PS measurement if used as an adjunct to abdominal radiographs would improve the identification and predication of infants with NEC.

Methods Serum PC/PS activity was measured according to protocol at early stage and recover stage of NEC. When clinical signs persisted and the initial abdominal radiographs were abnormal, follow-up radiographs were obtained. Results. Of 45 infants who were evaluated for gastrointestinal signs, only 2 had ileus or benign pneumatosis intestinalis with persistently normal PC/PS; gastrointestinal manifestations resolved within 48 hours, antibiotics were discontinued in < 48 hours, and feedings were restarted early without complications. 35 infants had NEC stages II and III; all had decreased PC/PS activity regardless of their blood culture results. PC/PS activity negatively correlative with severity of NEC and positively correlative with the recover form NEC.

Conclusions In infants with suspected NEC, normal PC/PS values would favor aborted antibiotic therapy and early resumption of feedings. PC/PS becomes significantly lower in both stage II and stage III NEC. In infants with NEC, persistently decreased PC/PS after initiation of appropriate medical management suggests associated complications, which may require surgical intervention.

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.