| 常栋喆,孙忠源,周良.血清 HBD-3、TLR2对先天性巨结肠手术病儿术后感染的诊断价值[J].安徽医药,2026,30(10):2070-2074. |
| 血清 HBD-3、TLR2对先天性巨结肠手术病儿术后感染的诊断价值 |
| Diagnostic value of serum HBD-3 and TLR2 for postoperative infection in children undergoing surgery for Hirschsprung's disease |
| |
| DOI：10.3969/j.issn.1009-6469.2026.10.031 |
| 中文关键词: 先天性巨结肠 β-防御素 -3 Toll样受体 2 术后感染 诊断 |
| 英文关键词: Congenital megacolon Human β-defensin 3 Toll like receptor 2 Postoperative infection Diagnosis |
| 基金项目:河南省医学攻关计划项目( LHGJ20200933) |
|
| 摘要点击次数: 107 |
| 全文下载次数: 21 |
| 中文摘要: |
| 目的探讨血清 β-防御素 -3(HBD-3)、 Toll样受体 2(TLR2)对先天性巨结肠( HD)手术病儿术后感染的诊断价值。方法前瞻性选取 2019年 10月至 2023年 10月郑州大学附属儿童医院收治的进行 HD手术的病儿 80例作为 HD组，根据其术后是否感染分为感染组(n=34)和未感染组(n=46)并统计感染组病儿病原菌的分布情况，另选取同期健康儿童 53例作为健康组。采用酶联免疫吸附分析(ELISA)检测血清 HBD-3、T，LR2水平，多因素 logistic回归分析筛选影响 HD病儿术后感染的相关因素，相对危险度分析不同血清 HBD-3、TLR2水平对 HD病儿术后发生感染的影响；受试者操作特征曲线(ROC曲线)分析血清 HBD-3、TLR2水平对 HD病儿术后感染的诊断价值。结果与健康组相比， HD组血清 HBD-3［( 248.25±40.63)ng/L比( 132.74±29.61)ng/L］、 TLR2［(13.50±2.81)μg/L比(5.21±1.19)μg/L］水平均升高(P<0.05)； 80例进行 HD手术病儿中，术后感染 34例(42.5%)，共分离出 49株病原菌，以革兰阴性菌为主(31株， 63.27%)；感染组病儿血清 HBD-3［(298.15±53.42)ng/L比(211.37±38.76)ng/L］、TLR2［(16.41±3.54)μg/L比( 11.35±2.29)μg/L］水平均高于未感染组( P<0.05)；且血清 HBD-3［( 247.89±42.51)ng/L比( 295.43±49.62)ng/L比(338.42±52.47)ng/L］、TLR2［(13.29±1.75)μg/L比(16.52±2.04)μg/L比(18.53±2.17)μg/L］水平均随感染程度的加重而逐渐升高(P <0.05)；血清 HBD-3(OR=3.11)、TLR2(OR=2.85)水平升高是影响 HD病儿术后发生感染的危险因素(P<0.05)；血清 HBD-3、TLR2高水平的 HD病儿术后发生感染的风险分别是低水平病人的 2.09、1.97倍；血清 HBD-3、TLR2二者联合诊断 HD病儿术后感染的 AUC为 0.96，二者联合的诊断价值优于各指标单独诊断(Z二者联合 -HBD-3=3.07、Z二者联合 -TLR2=2.62，P<0.05)。结论 HD术后感染病儿血清 HBD-3、TLR2水平显著升高，二者联合检测能够为临床诊断 HD病儿术后感染提供重要参考价值。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of serum human β-defensin 3 (HBD-3) and toll like receptor 2 (TLR2) in postoperative infection among children undergoing surgery for Hirschsprung disease (HD).Methods A total of 80 children who re-ceived HD surgery in the Children's Hospital Affiliated to Zhengzhou University from October 2019 to October 2023 were prospective-ly enrolled as the HD group. According to the presence or absence of postoperative infection, the HD group wasfurther divided into theinfection subgroup (n = 34) and the non-infection subgroup (n = 46), and the distribution of pathogenic bacteria in infected children wasstatistically analyzed. Meanwhile, 53 healthy children during the same period were recruited as the healthy control group. Enzyme-linked immunosorbent assay (ELISA) was performed to detect the serum levels of HBD-3 and TLR2. Multivariate logistic regressionanalysis was applied to screen the related factors for postoperative infection in children with HD. Relative risk analysis was used toevaluate the influence of different serum HBD-3 and TLR2 levels on the occurrence of postoperative infection. Receiver operating char-acteristic curve (ROC curve) analysis was conducted to assess the diagnostic efficacy of serum HBD-3 and TLR2 for postoperative infec-tion in HD children.Results Compared with the healthy control group, the HD group exhibited significantly higher serum levels of HBD-3 [(248.25±40.63) ng/L vs. (132.74±29.61) ng/L] and TLR2 [(13.50±2.81) μg/L vs. (5.21±1.19) μg/L] (P<0.05). Among 80 chil-dren who underwent HD surgery, 34 cases (42.5%) had postoperative infections, and a total of 49 strains of pathogenic bacteria were isolated, mainly Gram negative bacteria (31 strains, 63.27%). The serum levels of HBD-3 [(298.15±53.42) ng/L vs. (211.37±38.76) ng/ L] and TLR2 [(16.41±3.54) μg/L vs. (11.35±2.29) μg/L] in the infection subgroup were significantly higher than those in the non-infec-tion subgroup (P<0.05); Additionally, serum HBD-3 [(247.89±42.51) ng/L vs. (295.43±49.62) ng/L vs. (338.42±52.47) ng/L] and TLR2 [(13.29±1.75) μg/L vs. (16.52±2.04) μg/L vs. (18.53±2.17) μg/L] levels increased gradually with the aggravation of infection severity (P <0.05). Elevated levels of serum HBD-3(OR=3.11) and TLR2 (OR=2.85) were risk factors for postoperative infection in HD patients (P <0.05). The risks of postoperative infection in HD patients with high serum HBD-3 and TLR2 were 2.09 times and 1.97 times higher, respectively, than those in patients with low levels. The joint of serum HBD-3 and TLR2 had an area under the curve (AUC) of 0.96 fordiagnosing postoperative infection in HD patients, and the diagnostic value of the joint was better than that of individual diagnosis(Zjoint-HBD-3=3.07, Z joint-TLR2=2.62, P<0.05).Conclusion The serum HBD-3 and TLR2 are prominently elevated in HD children with post-operative infection. The joint detection of the two can provide important reference value for the clinical diagnosis of postoperative infec-tion in children with HD. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
