关键词:

先天性巨结肠, 小肠结肠炎, 预测, Neuroligin2, 生长相关蛋白43, 儿童

Abstract:

Objective　To investigate the relationship between Neuroligin2 and growth-associated protein 43 (GAP-43) and Hirschsprung associated enterocolitis (HAEC) after surgery in children with Hirschsprung's disease and their combined predictive value. Methods　Seventy-nine children with Hirschsprung's disease who underwent megacolonectomy in Zhoukou Central Hospital from July 2020 to July 2022 were selected as the study group, and 79 children who underwent health checkups in Zhoukou Central Hospital from July 2020 to July 2022 were selected as the control group. Seventy-nine children with Hirschsprung's disease were followed up for 6 months after operation, and according to whether they were complicated with HAEC during the postoperative follow-up, they were divided into a HAEC group (23 cases) and a non-HAEC group (56 cases). There were 43 males and 36 females in the study group, aged (8.92±0.84) months. There were 45 males and 34 females in the control group, aged (8.84±0.88) months. The relative expression levels of serum Neuroligin2 and GAP-43 were detected after admission, and their correlations with the complication of HACE and their predictive values for postoperative HAEC in children with Hirschsprung's disease were analyzed. χ² test was used for the count data, independent sample t test was used for the measurement data, Spearman correlation analysis was performed, logistic regression equation was used to analyze the related influencing factors, and receiver operating characteristic curve (ROC) was used for predictive value analysis. Results　The relative expression levels of serum Neuroligin2 and GAP-43 in the study group [(0.35±0.03) and (1.52±0.31)] were lower than those in the control group [(0.79±0.07) and (2.47±0.39)], with statistically significant differences (t=51.351 and 16.949, both P<0.001). The relative expression levels of serum Neuroligin2 and GAP-43 in the HAEC group [(0.12±0.03) and (0.74±0.06)] were lower than those in the non-HAEC group [(0.44±0.05) and (1.84±0.12)], with statistically significant differences (t=28.587 and 41.756, both P<0.001). The relative expression levels of Neuroligin2 and GAP-43 in serum were negatively correlated with concurrent HACE (both P<0.05). Serum Neuroligin2 relative expression level (>0.35) and GAP-43 relative expression level (>1.52) were protective factors for postoperative HAEC in children with Hirschsprung's disease (both P<0.05). The area under the curve (AUC) of the combination of serum Neuroligin2 and GAP-43 in predicting HAEC in children with Hirschsprung's disease was 0.802, with the best predictive sensitivity and specificity of 86.96% and 73.21%, respectively. Conclusion　The relative expression levels of serum Neuroligin2 and GAP-43 in children with Hirschsprung's disease can be used in the assessment and prediction of postoperative HAEC, providing a reference basis for early and targeted clinical intervention to improve the prognosis.

Key words:

Hirschsprung's disease, Enterocolitis, Prediction, Neuroligin2, GAP-43, Children