血清SDF-1、sTREM-1对小儿肠套叠术后发生医院感染的诊断价值

Diagnostic value of serum SDF-1 and sTREM-1 for nosocomial infection after pediatric intussusception surgery

目的探讨血清基质细胞衍生因子-1(SDF-1)、可溶性髓细胞触发受体-1(sTREM-1)对小儿肠套叠术后发生医院感染的诊断价值。方法选取2020年8月至2022年8月在首都医科大学附属北京儿童医院保定医院接受肠套叠术的108例患儿作为研究组,根据肠套叠术后是否发生医院感染分为感染组(35例)和未感染组(73例)。另选取同时期在首都医科大学附属北京儿童医院保定医院进行健康体检的108例健康儿童作为对照组。收集所有研究对象的基线资料。采用酶联免疫吸附试验检测所有研究对象血清SDF-1、sTREM-1水平。采用多因素Logistic回归分析小儿肠套叠术后发生医院感染的影响因素。绘制受试者工作特征(ROC)曲线分析血清SDF-1、sTREM-1单独及二者联合检测对小儿肠套叠术后发生医院感染的诊断价值。结果研究组血清SDF-1、sTREM-1水平均明显高于对照组,差异均有统计学意义(P<0.05)。感染组与未感染组年龄、性别、病程、病理类型比例比较,差异均无统计学意义(P>0.05)。感染组中转开腹比例、血清SDF-1、sTREM-1水平均高于未感染组,手术时间长于未感染组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清SDF-1、sTREM-1、中转开腹、手术时间均为小儿肠套叠术后发生医院感染的影响因素(P<0.05)。ROC曲线分析结果显示,血清SDF-1、sTREM-1单独及二者联合诊断小儿肠套叠术后发生医院感染的曲线下面积(AUC)分别为0.840、0.778、0.918,二者联合诊断的AUC大于血清SDF-1、sTREM-1单独诊断的AUC(Z_(二者联合-SDF-1)=2.165,P=0.030;Z_(二者联合-sTREM-1)=3.282,P=0.001)。结论肠套叠术后发生医院感染的患儿血清SDF-1、sTREM-1水平均明显升高,二者联合检测对小儿肠套叠术后发生医院感染有较高的诊断价值。

Objective To investigate the diagnostic value of serum stromal cell-derived factor-1(SDF-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)for nosocomial infection after pediatric intussusception surgery.Methods A total of 108 children who underwent intussusception surgery in Baoding Hospital,Beijing Children′s Hospital Affiliated to Capital Medical University from August 2020 to August 2022 were selected as the study group.According to whether nosocomial infection occurred after intussusception surgery,they were divided into infected group(35 cases)and non-infected group(73 cases).Another 108 healthy children who underwent physical examination in Baoding Hospital,Beijing Children′s Hospital Affiliated to Capital Medical University during the same period were selected as the control group.The basic of all subjects were collected.The serum SDF-1 and sTREM-1 levels of all subjects were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of nosocomial infection after pediatric intussusception surgery.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum SDF-1,sTREM-1 alone and their combination for nosocomial infection after pediatric intussusception surgery.Results The serum levels of SDF-1 and sTREM-1 in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in age,gender,course of disease and proportion of pathological types between the infected group and the non-infected group(P>0.05).The proportion of conversion to laparotomy,serum SDF-1 and sTREM-1 levels in the infected group were higher than those in the non-infected group,and the operation time was longer than that in the non-infected group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that serum SDF-1,sTREM-1,conversion to laparotomy,and operation time were the influencing factors of nosocomial infection after pediatric intussusception surgery(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum SDF-1,sTREM-1 alone and their combination in the diagnosis of nosocomial infection after pediatric intussusception surgery were 0.840,0.778 and 0.918 respectively.The AUC of the combined diagnosis of SDF-1 and sTREM-1 was greater than that of serum SDF-1 and sTREM-1 alone(Z_(combined with SDF-1)=2.165,P=0.030,Z_(combined with sTREM-1)=3.282,P=0.001).Conclusion The serum SDF-1 and sTREM-1 levels are significantly increased in children with nosocomial infection after intussusception surgery.The combined detection of SDF-1 and sTREM-1 has a high diagnostic value for nosocomial infection after intussusception surgery in children.