HoxD-13在先天性肛门直肠畸形患儿末端直肠组织中的表达意义及与切口感染的关系  

Expression and Significance of HoxD-13 in Terminal Rectum Tissue of Children with Congenital Anorectal Malformation and Its Relationship with Incision Infection

作　　者：姚远 侯崇智[1] 程涛 刘燕飞 潘伟康[3] YAO Yuan;HOU Chong-zhi;CHENG Tao;LIU Yan-fei;PAN Wei-kang(Section 1 of General Surgery Department,Xi'an Children's Hospital,Xi’an,Shaanxi,710003,China;Department of Pathology,Xi'an Children's Hospital,Xi'an,Shaanxi,710003,China;Department of Pediatric Surgery,2nd Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710004,China)

机构地区：[1]西安市儿童医院普外一科,陕西西安710003 [2]西安市儿童医院病理科,陕西西安710003 [3]西安交通大学第二附属医院小儿外科,陕西西安710004

出　　处：《现代生物医学进展》2020年第23期4565-4570,共6页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81701501)。

摘　　要：目的:探讨Hox D-13在先天性肛门直肠畸形(CAM)患儿末端直肠组织中的基因表达意义及与术后切口感染的关系。方法:选择2015年6月-2019年06月CAM患儿71例作为观察组,选择非CAM患儿12例作为对照组。采用实时荧光PCR(RT-PCR)检测两组直肠末端组织Hoxd-13基因表达情况;记录观察组性别、年龄、体重、CAM临床分型、其它系统合并畸形情况、手术方式、成形次数、是否发生术后切口感染等,分析上述不同情况下Hox D-13基因表达水平的差异;采用线性回归分析CAM临床分型与合并其它畸形情况、Hox D-13基因表达水平的关系;观察术后切口感染相关因素,采用单因素分析、二元Logistic分析探索切口感染的危险因素。结果:观察组CAM患儿末端直肠组织中Hox D-13相对表达量低于对照组,差异有统计学意义(P<0.05)。合并其它畸形患儿的Hox D-13相对表达量低于未合并患儿,差异具有统计学意义(P<0.05)。中高位CAM患儿合并其它畸形患病率72.09%,高于低位CAM患儿(21.43%),差异具有统计学意义(P<0.05);中高位CAM患儿的Hox D-13相对表达量低于低位CAM,差异具有统计学意义(P<0.05);线性回归提示Hox D-13相对表达量是影响临床分型的主要因素(t=4.714,P=0.000)。切口感染单因素分析提示,发生术后切口感染的CAM患儿的临床分型、合并其他畸形情况及直肠末端组织Hox D-13相对表达量与未发生切口感染患儿相比,存在统计学差异(P<0.05);二元Logistic分析结果表明,Hox D-13是术后切口感染的危险因素(Waldχ2值=7.440,P=0.006)。结论:Hox D-13基因在CAM患儿末端直肠组织中呈低表达,可能是CAM临床分型及合并其它畸形的主要因素,且可能是术后切口感染的危险因素,因此对胎儿或患儿Hoxd-13基因表达情况进行检测有一定的临床价值。Objective: To investigate the gene expression and significance of Hox D-13 in the terminal rectal tissue of children with congenital anorectal malformation(CAM) and its relationship with incision infection after operation. Methods: 71 children with CAM from June 2015 to June 2019 were selected as the observation group, and 12 children without CAM were selected as the control group.Real-time fluorescent PCR(RT-PCR) was used to detect the Hox D-13 gene expression of terminal rectum tissue. The case data of the observation group as gender, age, weight, clinical type of CAM, other system combined malformations, operation mode, shaping times and postoperative incision infection were recorded, and the differences of Hoxd-13 gene expression levels in the above cases were analyzed. Analysis of the relationship between clinical type of CAM with other combined malformations or Hoxd-13 gene expression levels were done according to linear regression. The related factors of postoperative incision infection were observed, and then the risk factors of incision infection were investigated by single factor analysis and binary logistic analysis. Results: The relative expression level of HoxD-13 in the terminal rectal tissue of children with CAM was significantly lower than that of the control group(P<0.05). The relative expression of Hoxd-13 in children with other combined malformations was significantly lower than that in children without other malformations(P<0.05). In children with middle and high cam, the prevalence of other combined malformations was significantly higher than that in children with low cam(72.09% vs. 21.43%)(P<0.05), and the relative expression of Hoxd-13 was significantly lower than that in children with low cam(P<0.05), and according to the linear regression, the relative expression of Hoxd-13 was the main factor affecting clinical type(t=4.714, P=0.000). The single factor analysis of incisional infection indicated that there were statistical differences in clinical type, other combined malformations and the

关 键 词：HoxD-13基因 先天性肛门直肠畸形 末端直肠组织 切口感染 

分 类 号：R657.1[医药卫生—外科学] R726.1[医药卫生—临床医学]