探究多螺旋CT联合HMGB1检测在儿童先天性胸廓畸形中诊断价值

Value of Multi-spiral CT Combined with HMGB1 in Diagnosis of Congenital Thoracic Malformations in Children

目的探究多螺旋CT联合HMGB1检测在儿童先天性胸廓畸形中诊断价值。方法选取2021年3月~2023年3月于我院就诊的57例疑似胸廓畸形患儿作为研究对象,以手术诊断为“金标准”,将确诊为胸廓畸形的43例患儿作为观察组,其余14例非胸廓畸形患儿作为对照组。分别检测观察组与对照组血清HMGB1水平。观察组患儿进行MSCT扫描检查,记录其CT相关数据。比较基础资料、不同亚型、不同急性严重程度之间CT相关数据及血清HMGB1水平;比较MSCT扫描、血清HMGB1水平检测及二者联合对先天性漏斗胸的检出率及诊断价值。结果对照组与观察组患儿性别、年龄、BMI方面比较无明显差异(P>0.05),观察组患儿血清HMGB1水平明显高于对照组(P<0.05)。不同亚型漏斗胸患儿Hailer指数、心脏旋转角、胸骨凹陷深度、CT凹陷指数、胸骨凹陷角度、血清HMGB1水平比较,无明显差别(P>0.05)。轻度漏斗胸患儿Hailer指数、心脏旋转角、胸骨凹陷深度、CT凹陷指数、血清HMGB1水平均低于中度、重度漏斗胸患儿,胸骨凹陷角度高于中度、重度漏斗胸患儿(P<0.05);中度漏斗胸患儿Hailer指数、心脏旋转角、胸骨凹陷深度、CT凹陷指数、血清HMGB1水平低于重度漏斗胸患儿,胸骨凹陷角度高于重度漏斗胸患儿(P<0.05)。MSCT联合HMGB1检测漏斗胸检出率是90.70%,远高于MSCT扫描的69.77%、血清HMGB1水平检测的41.86%(P<0.05)。ROC曲线分析MSCT扫描、血清HMGB1、二者联合检测对先天性漏斗胸灵敏度及特异度分析发现,二者联合检测的灵敏度、特异性及AUC均高于MSCT扫描及血清HMGB1。结论MSCT联合HMGB1检测能高效诊断出儿童先天性胸廓畸形,具有较高诊断价值。

Objective To explore the diagnostic value of multi-spiral CT combined with HMGB1 in children with congenital thoracic malformations.Methods Fifty-seven children with suspected thoracic malformation treated in our hospital from March 2021 to March 2023 were selected as the study objects.With surgical diagnosis as the"gold standard",43 children with confirmed thoracic malformation were selected as the observation group,and the other 14 children with non-thoracic malformation were selected as the control group.Serum HMGB1 levels were detected in observation group and control group.The children in observation group were examined by MSCT scan,and the relevant CT data were recorded.The basic data of the control group and the observation group were compared.CT data and serum HMGB1 levels of different subtypes and acute severity were compared in the observation group.To compare the detection rate and diagnostic value of MSCT scanning,serum HMGB1 level detection and their combination in congenital infundibular chest.Results There were no significant differences in gender,age and BMI between control group and observation group(P>0.05).Serum HMGB1 level in observation group was significantly higher than that in control group(P<0.05).There were no significant differences in Hailer index,cardiac rotation Angle,sternal depression depth,CT depression index,sternal depression Angle and serum HMGB1 level among children with different subtypes of infundibular chest(P>0.05).The Hailer index,heart rotation Angle,depth of sternal depression,CT depression index and serum HMGB1 level in children with mild infundibular chest were lower than those in children with moderate and severe infundibular chest,and the Angle of sternal depression was higher than those in children with moderate and severe infundibular chest(P<0.05).The Hailer index,cardiac rotation Angle,sternal depression depth,CT depression index and serum HMGB1 level in children with moderate infundibular chest were lower than those with severe infundibular chest,and the sternal depression Angle was higher than those with severe infundibular chest(P<0.05).The detection rate of funnel chest by MSCT combined with HMGB1 was 90.70%,which was much higher than 69.77%by MSCT scan and 41.86%by serum HMGB1 level detection(P<0.05).ROC curve analysis of the sensitivity and specificity of MSCT scan,serum HMGB1,and combined detection for congenital infundibulus chest showed that the sensitivity,specificity and AUC of the combined detection were higher than that of MSCT scan and serum HMGB1.Conclusion MSCT combined with HMGB1 can effectively diagnose congenital thoracic malformation in children,and has high diagnostic value.