摘要
目的探讨先天性巨结肠患者血清miR-223与炎性因子水平及其临床意义。方法选取2017年1月至2018年8月在枣庄市立医院行先天性巨结肠(Hirschsprung disease,HD)根治术的患者66例(观察组)作为研究对象,同时参照HD患者基线资料选取同期健康患者70例作为健康组。术后随访6个月,根据术后随访是否出现小肠结肠炎(Hirschsprung associated enterocolitis,HAEC)将观察组患者分为HAEC组(n=20)和非HAEC组(n=46)。对比分析所有患者术前血清miR-223、TNF-α、IL-6、IL-8水平,并进行术后HAEC的多因素Logistic分析及ROC曲线分析。结果观察组患者血清miR-223、TNF-α、IL-6、IL-8均高于健康组(P<0.05)。HAEC组患者血清miR-223、TNF-α、IL-6、IL-8高于非HAEC组(P<0.05)。HD患者术前高表达的血清miR-223、TNF-α、IL-6、IL-8均是术后发生HAEC的独立危险因素(P<0.05)。HD患者术前血清miR-223、IL-6、TNF-α、IL-8预测术后HAEC的AUC面积分别为0.889、0.826、0.678、0.657,对应截断值分别为3.90(灵敏度:86.70%,特异度:80.00%)、34.20 pg/ml(灵敏度:83.30%,特异度:75.00%)、45.15 pg/ml(灵敏度:60.00%,特异度:75.00%)、21.60 pg/ml(灵敏度:60.00%,特异度:80.00%)。结论先天性巨结肠患者术前血清miR-223、IL-6、TNF-α、IL-8呈高表达,且是术后小肠结肠炎的危险因素。同时术前血清miR-223、IL-6、TNF-α、IL-8对术后小肠结肠炎的发生具有较高的预测价值,临床可通过对术前相关指标的检测,进行术后HAEC的风险评估,以及时采取干预方案,提高患者生存质量。
Objective To explore the clinical significance of serum levels of mir-223 and inflammatory factors in children with Hirschsprung's disease(HD).Methods From January 2017 to August 2018,66 children undergoing radical operations for HD were selected as study subjects while another 70 healthy counterparts in the same period were selected as healthy group according to the baseline data.The observation group were further divided into HAEC group(n=20)and non-AEC group(n=46).The serum levels of mir-223,TNF-α,IL-6 and IL-8 were compared and analyzed before and after operation and analyses of multiple factor and ROC curve of HAEC were conducted.Results The serum levels of mir-223,TNF-α,IL-6 and IL-8 in observation group were significantly higher than those in healthy group(P<0.05)while those in HAEC group were significantly higher than those in non-HAEC group(P<0.05).Serum levels of mir-223,TNF-α,IL-6 and IL-8 were independent risk factors of HAEC(P<0.05).The AUC of HAEC was 0.889,0.826,0.678 and 0.657 as predicted by mir-223,IL-6,TNF-α and IL-8 respectively.The corresponding cutoff values were 3.90(sensitivity=86.70%,specificity=80.00%),34.20(sensitivity=83.30%,specificity=75.00%),45.15(sensitivity=60.00%,specificity=75.00%)and 21.60(sensitivity=60.00%,specificity=80.00%).Conclusion The pre-operative serum levels of mir-223,IL-6,TNF-α and IL-8 in HD children are significantly up-regulated and they are risk factors of postoperative enterocolitis.At the same time,the preoperative serum levels of mir-223,IL-6,TNF-α and IL-8 have a high predictive value for the postoperative occurrence of enterocolitis.Clinical interventions may adopted timely through detecting the relevant preoperative indicators for assessing the risk of postoperative HAEC and improving the quality-of-life of children.
作者
陈宏坤
张大森
Chen Hongkun;Zhang Dasen(Department of Pediatric Surgery,Municipal Hospital,Zaozhuang 277100,China)
出处
《临床小儿外科杂志》
CAS
CSCD
2021年第4期359-364,共6页
Journal of Clinical Pediatric Surgery
