STAT3表达对先天性肠闭锁合并腹腔感染患儿的预后影响  

Effect of STAT3 expression on the prognosis of children with congenital intestinal atresia complicated with abdominal infection

作　　者：董彦清[1] 牛会忠[1] 张鹏举[1] 任慧[1] 陈盼[1] 张治广 牛波波 DONG Yanqing;NIU Huizhong;ZHANG Pengju;REN Hui;CHEN Pan;ZHANG Zhiguang;NIU Bobo(Department of General Surgery,Hebei Provincial Children’s Hospital,Shijiazhuang,Hebei 050031,China)

机构地区：[1]河北省儿童医院普外科,河北石家庄050031

出　　处：《中国国境卫生检疫杂志》2024年第4期381-385,共5页Chinese Journal of Frontier Health and Quarantine

基　　金：河北省卫健委科研计划项目(20231148)。

摘　　要：目的 探究信号转导和转录激活子3(STAT3)对先天性肠闭锁合并腹腔感染患儿的预后影响,为其防治提供依据。方法 选取2020年1月-2023年1月河北省儿童医院收治的先天性肠闭锁合并腹腔感染患儿106例,采用PCR法测定患儿病变肠组织中STAT3 mRNA的相对表达量。根据术后6个月治疗结局分为存活组和死亡组,筛查先天性肠闭锁合并腹腔感染患儿预后的影响因素,分析STAT3表达与先天性肠闭锁合并腹腔感染患儿预后的关系。结果 106例先天性肠闭锁合并腹腔感染患儿中有68例存活,存活率为64.15%。死亡组早产、低体重、Grosfeld病理类型Ⅲ~ Ⅳ型、术后短肠综合征的占比及Th17细胞、IL-6、STAT3 mRNA高于存活组(P<0.05),TGF-β低于存活组(P<0.05)。Grosfeld病理类型(HR=2.672,95%CI:1.126~6.344)、术后短肠综合征(HR=3.777,95%CI:1.115~12.794)、Th17细胞(HR=4.899,95%CI:1.446~16.593)、IL-6(HR=5.068,95%CI:1.496~17.167)、STAT3 mRNA (HR=6.092,95%CI:1.798~20.634)是先天性肠闭锁合并腹腔感染患儿死亡的危险因素(P<0.05),TGF-β(HR=0.282,95%CI:0.083~0.954)是先天性肠闭锁合并腹腔感染患儿死亡的保护因素(P<0.05)。STAT3 mRNA预测先天性肠闭锁合并腹腔感染患儿死亡的曲线下面积为0.904(0.845~0.964)。不同STAT3 mRNA表达组患儿的生存曲线差异有统计学意义(P<0.05)。结论 STAT3 mRNA表达量升高与先天性肠闭锁合并腹腔感染患儿的不良预后有关。Objective To explore the prognostic effects of signal transducer and activator 3(STAT3)on children with congenital intestinal atresia complicated with abdominal infection,so as to provide a basis for its prevention and treatment.Methods A total of 106 infants with congenital intestinal atresia complicated by abdominal infection admitted to Hebei Children’s Hospital from January 2020 to January 2023 were enrolled.PCR method was used to determine the relative expression level of STAT3 mRNA in the affected intestinal tissues.According to the 6-month post operative treatment outcome,the patients were divided into survival group and death group,and the prognostic factors affecting infants with congenital intestinal atresia complicated by abdominal infection were screened.The rela-tionship between STAT3 expression and prognosis of infants with congenital intestinal atresia complicated by abdominal infection was analyzed.Results Out of the 106 cases of infants with congenital intestinal atresia complicated by abdominal infection,68 cases survived,with a survival rate of 64.15%.The premature birth,low birth weight,Grosfeld pathology types III-IV,postoperative short bowel syndrome,and the proportion of Th17 cells,IL-6 and STAT3 mRNA were higher in the death group than the survival group(P<0.05),while TGF-βwas lower than that of survival group(P<0.05).Grosfeld pathology type(HR=2.672,95%CI:1.126-6.344),postoperative short bowel syndrome(HR=3.777,95%CI:1.115-12.794),Th17 cells(HR=4.899,95%CI:1.446-16.593),IL-6(HR=5.068,95%CI:1.496-17.167),and STAT3 mRNA(HR=6.092,95%CI:1.798-20.634)were identified as risk factors for mortality in infants with congenital intestinal atresia complicated by abdominal infection(P<0.05)while TGF-β(HR=0.282,95%CI:0.083-0.954)was identi-fied as a protective factor(P<0.05).The area under the curve(AUC)for predicting mortality in infants with congenital intestinal atresia complicated by abdominal infection using STAT3 mRNA was 0.904(0.845-0.964).There was a statistically significant difference in

关 键 词：先天性肠闭锁 腹腔感染 信号转导和转录激活子3 预后 

分 类 号：R183[医药卫生—流行病学] R722.1[医药卫生—公共卫生与预防医学]