Objective To investigate the application value of serum transforming growth factor-β1 (TGF-β1) and intestinal alkaline phosphatase (IAP) in the diagnosis of severe neonatal necrotizing small bowel colitis (NEC).

Methods A total of 82 NEC neonates were selected as NEC group, and were divided into mild group(21 cases), moderate group(43 cases), and severe group(18 cases) according to the modified Bell-NEC stage, and another 80 healthy neonates were selected as control group during the same period. Serum TGF-β1 and IAP levels were detected in each group. The correlations of serum TGF-β1 and IAP levels with Bell-NEC stage were analyzed by Spearman rank correlation, and receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum TGF-β1 and IAP levels on NEC in critically ill neonates.

Results Compared with the control group, serum TGF-β1 and IAP levels were reduced in the NEC group (P<0.05). The serum TGF-β1 and IAP levels of children with NEC in the mild, moderate, and severe groups were reduced sequentially (P<0.05). Spearman's rank correlation analysis showed that serum TGF-β1 and IAP levels in children with NEC stage were negatively correlated with Bell-NEC stage (r_s=-0.669, -0.658, P<0.001). ROC curve analysis showed that the area under the curve of serum TGF-β1 and IAP levels alone and their combination in the diagnosis of severe neonatal NEC was 0.783, 0.780, and 0.905, respectively.

Conclusion Decreased serum TGF-β1 and IAP levels in NEC neonates are associated with severity of disease, and the combined serum TGF-β1 and IAP levels are of high value in the diagnosis of severe neonatal NEC and may be an auxiliary diagnostic index for severe neonatal NEC.