الفهرس 
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Abstract
SUMMARY
ecrotizing enterocolitis an important source of morbidity and mortality in preterm infants.
The aim of our study was to assess the value of peripheral blood neutrophil to lymphocyte ratio (NLR), serum levels of γ-glutamyl transferase (GGT), total serum bilirubin and serum calcium (Ca2+) concentrations for early diagnosis and prediction of NEC severity; and to make a predictive score for early diagnosis of NEC.
Our case control study was conducted on 50 preterm neonates in the period from June 2019 to December 2019 in the neonatal intensive care units (NICUs), Children’s Hospital, Ain Shams University, Cairo, Egypt.
Inclusion criteria:
Patient group: NEC preterm neonates with gestational ages are between 28-36 weeks regardless of birth weight. NEC diagnosis and staging will be according to Bell’s staging criteria.
Control group: Stable preterm neonate with matched gestational and postnatal.
N
Summary
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Exclusion Criteria:
Neonates with congenital infectious diseases, perinatal asphyxia, severe birth defects, congenital digestive tract malformations, inherited metabolic diseases or parental refusal of enrollment.
Results:
Cases and controls were properly matched as evidenced by lack of statistical significant difference between both groups.
Neonates who received blood transfusion or who on formula feeding or who needed ventilator support were more liable to develop NEC than others.
There is statistical difference between the two groups regarding laboratory results at diagnosis regarding neutrophils count, lymphocytes count, NLR, hemoglobin level, platelets count, PH and bicarbonate in blood gases, calcium, GGT, total bilirubin, BUN, Creatinine, AST, CRP, albumin, PT, PTT and INR.
As regard to the laboratory results before and after recovery from NEC, there was statistical difference regarding the results of neutrophils/lymphocytes ratio, platelets count, CRP, GGT, creatinine, calcium, PH and bicarbonate in blood gases, PT, PTT and INR.
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However, there was no statistical difference regarding results of total leukocytic Count, neutrophils count, lymphocytes, hemoglobin, sodium, potassium, BUN, AST, ALT, albumin, phosphorus, magnesium, PCO2 and total bilirubin.
Neonates who had positive blood culture, had ECHO abnormality, PDA and PAUS abnormality was more liable to develop NEC.
NEC cases were liable to have positive blood cultures mostly Staphylococcus coagulase negative organism.
10 (40.0%) NEC cases were stage 2b, 7 (28.0%) were stage 2a, 6 (24.0%) were stage 3b, 2 (8.0%) were stage 3a, none were stage 1.
ROC curve of Neutrophil/Lymphocyte ratio, GGT, total serum bilirubin and calcium showed significant value in diagnosis of NEC but cannot discriminate between stage 2 and stage 3.
Non-survivors NEC neonates were more likely to have lower gestational ages, higher N/L ratio, lower PH and higher BUN.
Finally, we made a predictive score for diagnosis neonatal NEC depending on NLR and GGT with sensitivity 92% and specificity 92%