Objective To investigate correlations of dynamic changes in serum C-reactive pro-tein(CRP),procalcitonin(PCT),and neutrophil-to-lymphocyte ratio(NLR)before and after symptomatic treatment with prognosis of neonates with neonatal respiratory distress syndrome(NRDS)of different etiologies.Methods A total of 110 premature infants were selected as study subjects and divided into neonatal infection group(group A)and fetal intrauterine distress group(group B)based on different causes of NRDS.Additionally,30 neonates with NRDS caused solely by prematurity were selected as control group.Serum CRP and PCT levels and NLR were compared among the three groups before and after treatment.Results There were statistically significant differences in oxygen therapy duration,ventilation duration,the proportion of infants requiring re-intubation,hospital stay,and the number of apnea episodes among three groups(P＜0.006).Before treatment,there was no sta-tistically significant difference in serum CRP levels between group A and group B(P＞0.05).Ser-um CRP levels in group B were higher than those in the control group.Moreover,serum PCT levels was lower than the group A,and NLR in the group B were higher than those in the group A and the control group.CRP,PCT levels,and NLR in the group A were higher than those in the control group(P＜0.05 or P＜0.006).After treatment,serum CRP levels in all three groups decreased compared to before treatment.Serum PCT levels in the group A decreased compared to before treat-ment.NLR in both group A and group B decreased compared to before treatment,with statistically significant differences(P＜0.006).There were statistically significant differences in serum CRP and PCT levels between the group A and the control group after treatment(P＜0.006).After treat-ment,there was a statistically significant difference in serum CRP levels between the group B and the control group(P＜0.006),but no statistically significant differences in PCT levels and NLR(P＞0.05).Compared with group A,there was a statistically significant difference in PCT levels in the group B(P＜0.006).Multivariate Logistic regression results showed that CRP,PCT,and NLR were independent influencing factors for the prognosis of infants in the group A.The receiver operat-ing characteristic curve analysis results showed that the areas under the curve(AUC)after treatment for serum CRP,PCT,and NLR alone in predicting prognosis in the group A were 0.789,0.738,and 0.758,respectively,and the AUC for combined prediction was 0.934.In the group B,the AUC for serum CRP,PCT,and NLR alone in predicting prognosis after treatment were 0.719,0.772,and 0.768,respectively,and the AUC for combined prediction was 0.886.The sensitivity and specificity of combined prediction in both groups were higher than those of each indicator alone,and the predictive value of their combined detection for the prognosis of premature infants in group A was higher than that in the group B.Conclusion There are differences in PCT levels and NLR before treatment among neonates with NRDS of different etiologies.After symptomatic treatment,CRP,PCT levels and NLR decrease in all three groups,indicating a good prognosis.

Objective: To analyze the clinical risk factors of bronchopulmonary dysplasia(BPD) in very premature infants and provide reference for the prevention and treatment of BPD in order to improve the prognosis of premature infants. Methods: From January 2015 to December 2017, 263 very premature infants(referring to premature infants with gestational age between 28 weeks and 32 weeks) in the neonatology department of the Maternal and Child Health Care Hospital Affiliated to Anhui Medical University were selected.They were divided into BPD group(108 cases) and non-BPD group(155 cases) according to the diagnostic criteria of BPD.The clinical data of the patients and the hospitalized patients were retrospectively investigated.The general conditions of the very premature infants in the two groups were compared.The clinical risk factors for BPD in very premature infants were analyzed. Results: There were 263 very preterm infants included in the study, 108 cases in the BPD group, the incidence was 41.1%.The data analysis showed that BPD occurred in premature infants with sex(χ²=4.311), gestational age(Z=-6.544), birth weight(t=-5.382), maternal chorioamnionitis(χ²=4.946), neonatal respiratory distress syndrome(χ²=25.424), anemia(χ²=22.443), multiple blood transfusion(Z=-8.101), mechanical ventilation time greater than 7 days(χ²=10.946), high oxygen concentration(χ²=25.028), the differences were statistically significant(all P<0.05). The multivariate logistic regression analysis suggested that gestational age(OR=1.478, 95% CI: 1.140-1.914), maternal pregnancy with chorioamnionitis (OR=0.152, 95% CI: 0.029-0.797), maximum oxygen concentration>40%(OR=0.261, 95% CI: 0.136-0.502), number of blood transfusions(OR=0.582, 95% CI: 0.456-0.742) were independent risk factors for BPD in preterm infants. Conclusion There are many factors leading to BPD in premature infants, including maternal comorbidities and neonatal factors, and its pathogenesis is complex and diverse.It is necessary to further study these related factors, timely intervention, strengthen maternal health care, and minimize risk factors, thus to reduce the incidence of BPD, improve the prognosis of premature infants.