血清HMGB1联合MIP-1α检测在小儿急性阑尾炎诊断及病理分型中的应用  

Application of Serum HMGB1 Combined with MIP-1αDetection in the Diagnosis and Pathological Classification of Children with Acute Appendicitis

作　　者：张玮[1] 梁峰[1] 张敏 孙红[1] 张雪峰[1] 雷杰[1] 李庆丰[1] 王贵波[1] Zhang Wei;Liang Feng;Zhang Min;Sun Hong;Zhang Xuefeng;Lei Jie;Li Qingfeng;Wang Guibo(First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei Province,China;不详)

机构地区：[1]河北北方学院附属第一医院,河北省张家口市075000

出　　处：《中国病案》2021年第12期91-94,共4页Chinese Medical Record

基　　金：河北省卫计委医学科学重点课题计划(20180842);张家口市科技局指导性计划(1921057D)。

摘　　要：目的探讨血清高迁移率蛋白B1联合巨噬细胞炎性蛋白-1α检测在小儿急性阑尾炎诊断及病理分型中的应用价值。方法选取某院2019年2月1日-2020年10月31日期间收治的急性阑尾炎患儿119例为研究对象,进行回顾性分析,记为小儿急性阑尾炎组,依据患儿术后检测结果分为化脓性阑尾炎组(Ⅰ组,n=40),坏疽性阑尾炎及穿孔组(Ⅱ组,n=48)及单纯性阑尾炎组(Ⅲ组,n=31);随机选取同期在某院进行健康体检的儿童50例作为对照组。采用酶联免疫吸附法检测所有对象的MIP-1α及HMGB1水平。采用受试者工作特征曲线分析MIP-1α、HMGB1及联合诊断小儿急性阑尾炎的诊断效能,应用logistic回归分析其发病因素。结果急性阑尾炎组与对照组的血清HMGB1、MIP-1α水平比较,急性阑尾炎组血清HMGB1、MIP-1α水平均高于对照组,P<0.05;不同病理类型患儿的血清HMGB1、MIP-1α水平比较,干预前,Ⅱ组的HMGB1、MIP-1α水平明显高于Ⅰ组和Ⅲ组,P<0.05;干预后,Ⅰ组、Ⅱ组和Ⅲ组的HMGB1、MIP-1α水平均有明显下降,Ⅱ组>Ⅰ组>Ⅱ组,P<0.05;Logistic回归分析中,HMGB1和MIP-1α为小儿急性阑尾炎发病的独立危险因素,P<0.05;不同临床指标诊断效能比较中,血清HMGB1及MIP-1α诊断小儿急性阑尾炎的AUC为0.792、0.784,而联合诊断的AUC为0.862,且此时敏感度为82.33%,特异度为76.38%均高于单个指标,准确率为81.67%,高于单个指标。结论血清HMGB1联合MIP-1α具有良好的互补性,可提高小儿急性阑尾炎术前诊断的准确率,有利小儿急性阑尾炎的病理分型,对该病有较大的临床治疗指导意义,值得推广应用。Objective To investigate the value of serum high mobility protein B1(HMGB1)combined with macrophage inflammatory protein-1α(MIP-1α)in the diagnosis and pathological typing of children with acute appendicitis(AA).Methods 119 children with AA admitted to ourHospital from February 1,2019 to October 31,2020 were selected as the subjects of this study,and they were retrospectively analyzed and recorded as the AA group,and then the children were classified according to the postoperative test results Divided into suppurative appendicitis group(group Ⅰ,n=40),gangrenous appendicitis and perforation group(groupⅡ,n=48)and simple appendicitis group(group Ⅲ,n=31),and selected our hospital for physical examination at the same time 50 cases of healthy children served as a control group.Enzyme-linked immunosorbent assay was used to detect the levels of MIP-1α and HMGB1 in all subjects.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of MIP-1α,HMGB1 and the combined diagnosis of pediatric AA,and logistic regression was used to analyze the pathogenesis of pediatric AA.Results Comparing the serum HMGB1 and MIP-1α levels between the AA group and the control group,the serum HMGB1 and MIP-1α levels in the AA group were significantly higher than those in the control group(P<0.05);the serum HMGB1 and MIP-1α levels of children with different pathological types In the comparison of 1αlevels,before intervention,the HMGB1 and MIP-1α levels in group Ⅱ were significantly higher than those in groups Ⅰ and Ⅲ(P<0.05).After intervention,the HMGB1 and MIP-1α levels in groupsⅠ,Ⅱ and Ⅲ were significantly higher There was a significant decrease,and group Ⅱ>group Ⅰ>group Ⅱ(P<0.05);in logistic regression analysis,HMGB1 and MIP-1α were independent risk factors for the onset of AA in children(P<0.05);the diagnostic efficacy of different clinical indicators was being compared The AUC of serum HMGB1 and MIP-1α in the diagnosis of pediatric AA was 0.792 and 0.784,while the AUC of

关 键 词：高迁移率蛋白B1 巨噬细胞炎性蛋白-1Α 小儿 急性阑尾炎 病理分型 

分 类 号：R726.5[医药卫生—儿科]