高位隐睾患儿手术前后血管内皮生长因子、CD4^(+)/CD8^(+)水平变化与其支持细胞功能的关系探究

A The relationship between the changes of VEGF,CD4^(+)/CD8^(+) levels before and after operation in children with high cryptorchidism and the function of supporting cells

目的探讨高位隐睾患儿手术前后血管内皮生长因子(VEGF)、CD4^(+)/CD8^(+)水平变化与其支持细胞功能的关系。方法选取2018年1月至2020年12月恩施土家族苗族自治州中心医院收治的224例高位隐睾患儿作为观察组,另选取60例健康儿童作为对照组。观察组均行手术治疗,根据手术疗效分为疗效良好(n=204)与疗效不良(n=20)。对比两组VEGF、CD4^(+)/CD8^(+)、抗苗勒管激素(AMH)、抑制素B(INHB)水平,分析VEGF、CD4^(+)/CD8^(+)与AMH、INHB水平的相关性,对比不同疗效患儿手术前后VEGF、CD4^(+)/CD8^(+)、AMH、INHB水平,绘制受试者工作特征(ROC)曲线评价手术效果。结果观察组VEGF水平高于对照组,CD4^(+)/CD8^(+)、AMH、INHB水平均低于对照组,差异具有统计学意义(P<0.05);高位隐睾患儿VEGF水平与AMH、INHB水平均呈负相关,CD4^(+)/CD8^(+)与AMH、INHB水平均呈正相关(P<0.05);疗效不良患儿术后VEGF水平高于疗效良好患儿,CD4^(+)/CD8^(+)、AMH、INHB水平均低于疗效良好患儿,差异具有统计学意义(P<0.05);ROC曲线分析发现,VEGF、CD4^(+)/CD8^(+)与AMH、INHB水平联合评估手术疗效的曲线下面积(AUC)最大,为0.952,具有良好评估效能。结论高位隐睾患儿VEGF、CD4^(+)/CD8^(+)水平异常,且异常程度与支持细胞功能有关,联合检测可为临床评估手术效果提供参考。

Objective To investigate the relationship between vascular endothelial growth factor(VEGF)and CD4^(+)/CD8^(+)levels before and after surgery in children with high cryptorchidism and the function of supporting cells.Methods 224 children with high cryptorchidism from January 2018 to December 2020 in Central Hospital of Enshi Tujia and Miao Autonomous Prefecture were selected as the observation group,and another 60 healthy children were selected as the control group.All observation groups underwent surgical treatment and were divided into good efficacy(n=204)and poor efficacy(n=20)according to the surgical efficacy.The levels of VEGF,CD4^(+)/CD8^(+),anti-müllerian hormone(AMH)and inhibin B(INHB)were compared between the two groups,the correlation between VEGF,CD4^(+)/CD8^(+)and AMH and INHB levels was analysed,the levels of VEGF,CD4^(+)/CD8^(+),AMH and INHB were compared before and after surgery in children with different efficacy,and subject operating characteristic(ROC)curves were drawn to evaluate the effect of surgery.Results In the observation group,VEGF levels were higher than those in the control group,and CD4^(+)/CD8^(+),AMH and INHB levels were lower than those in the control group,with statistically significant differences(P<0.05);VEGF levels in children with high cryptorchidism were negatively correlated with AMH and INHB levels,and CD4^(+)/CD8^(+)were positively correlated with AMH and INHB levels(P<0.05);the postoperative VEGF levels of children with poor effecacy were higher than those of children with good efficacy,and the CD4^(+)/CD8^(+),AMH and INHB levels were lower than those of children with good efficacy,with statistically significant differences(P<0.05);the ROC curve analysis revealed that the AUC of the combination of VEGF,CD4^(+)/CD8^(+),AMH and INHB levels was the largest,at 0.952,with good assessment efficacy.Conclusions The levels of VEGF and CD4^(+)/CD8^(+)in children with high cryptorchidism are abnormal,and the degree of abnormality is related to the function of supporting cells.Combined detection can provide a reference for clinical evaluation of surgical effects.