Zhang Haisheng,Men Nan,Li Xuequn.Preoperative serum levels of IL-1β,I-FABP and PRDX1 in children with Hirschsprung‘s disease and their predictive values for postoperative enterocolitis[J].Journal of Clinical Pediatric Surgery,,():764-770.[doi:10.3760/cma.j.cn101785-202404039-011]
Preoperative serum levels of IL-1β,I-FABP and PRDX1 in children with Hirschsprung‘s disease and their predictive values for postoperative enterocolitis
- Keywords:
- Hirschsprung Disease; Enterocolitis; Interleukin-1; Fatty Acid-Binding Proteins; Intestine; Small; Oxidoreductases; Peroxidases; Correlation of Data; Forecasting
- Abstract:
- Objective To explore the serum levels of interleukin-1β (IL-1β),intestinal fatty acid binding protein (I-FABP) and peroxiredoxin-1 (PRDX1) in children with Hirschsprung‘s disease (HD) and examine their predictive values for postoperative Hirschsprung associated enterocolitis (HAEC). Methods From June 2021 to June 2023,178 HD children were recruited and another 150 healthy children undergoing physical examinations were regarded as control group.According to the presence or absence of postoperative HAEC,they were assigned into two groups of HAEC (n=52) and non-HAEC (n=126).Enzyme-linked immunosorbent assay (ELISA) was utilized for detecting the levels of C-reactive protein (CRP),tumor necrosis factor-alph (TNF-α),IL-1β,I-FABP and PRDX1.Pearson/Spearman‘s correlation analysis revealed that the levels of IL-1β,I-FABP and PRDX1 were correlated with length of spastic segment,history of enteritis,postoperative wound infection,postoperative intestinal obstruction and level of CRP/TNF-α.Receiver operating characteristic (ROC) curve was applied for analyzing the diagnostic value of IL-1β,I-FABP and PRDX1 levels for HAEC in HD children.Z-test was employed for comparing the differences in area under curve (AUC). Results Compared with the control group,the HD group had higher levels of IL-1β［(13.97±4.15)pg/mL vs.(8.74±2.73)pg/mL］,IFABP［(98.27±31.96)pg/mL vs.(56.24±18.12）pg/mL］,and PRDX1［(24.07±7.65）μg/L vs.(16.53±5.24）μg/L］(P<0.05).Compared with the non HAEC group,the HAEC group had higher proportions of spastic segment length of lesion (42.31% vs.24.60%),history of enteritis (48.08% vs.30.16%),postoperative wound infection (9.62% vs.1.59%),postoperative intestinal obstruction (11.54% vs.1.59%),and higher levels of serum CRP［(25.67±7.25）pg/mL vs.(18.34±5.64）pg/mL］,TNFα［(21.87±6.73)pg/mL vs.(15.28±4.67)pg/mL］,IL1β［(17.57±5.62)pg/mL vs.(12.48±3.84)pg/mL］,IFABP［(124.72±36.57)pg/mL vs.(87.35±28.63)pg/mL］,and PRDX1［(30.38±9.65)μg/L vs.(21.47±6.73)μg/L］,and a lower proportion of dietary control (P<0.05).The levels of IL-1β,I-FABP,and PRDX1 in the HAEC group were positively correlated with Spastic segment length of lesion (r=0.421、0.423、0.408),history of enteritis (r=0.417、0.426、0.415),postoperative wound infection (r=0.402、0.425、0.414),postoperative intestinal obstruction (r=0.432、0.428、0.434),CRP (r=0.411、0.416、0.415),TNF-α (r=0.409、0.403、0.407) levels,and negatively correlated with dietary control (P<0.05).The AUC for postoperative HAEC in HD patients diagnosed with serum IL-1β,I-FABP,and PRDX1 alone was 0.811 (95%CI:0.746-0.866)、0.803 (95%CI:0.737-0.859)、0.816 (95%CI:0.752-0.870),while the AUC for combined diagnosis was 0.946 (95%CI:0.902-0.974),which was better than their respective individual diagnoses (Ztriple combination - IL-1β=4.170,Ztriple combination- I-FABP=4.602,Ztriple combination-PRDX1=3.487,P<0.05). Conclusions As compared with healthy controls,serum levels of IL-1β,I-FABP and PRDX1 are higher in HD children.Further analysis indicates that the higher preoperative serum levels of IL-1β,I-FABP and PRDX1,the greater postoperative risk of HAEC in HD children.As compared with individual diagnosis,a combined diagnosis has higher clinical guidance significance.
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Memo
收稿日期:2024-4-16。
基金项目:河北省医学科学研究重点课题计划项目(20240471)
通讯作者:张海生,Email:knownowg@163.com