关键词: 开放性胃肠手术, 降钙素原, 正五聚蛋白3, 高迁移率族蛋白B1, 感染

Abstract: Objectiv To analyze the expression of serum procalcitonin (PCT),pentraxin 3 (PTX3) and high mobility group protein B1 (HMGB-1) in children after open gastrointestinal surgery and their application value in early infection prediction.Methods A retrospective analysis was performed on 206 children with open gastrointestinal surgery admitted to the hospital from January 2020 to January 2023.They were divided into infection group (27 case) and non-infection group (179 case) according to whether they had postoperative infection.The levels of serum PCT,PTX3 and HMGB-1 before operation,1 d and 3 d after operation were compared between the two groups.The predictive value of single and combined detection of serum indexes 1 d and 3 d after operation for postoperative infection in children with open gastrointestinal surgery was observed.The influencing factors of postoperative infection were analyzed by multivariate Logistic regression.Results The levels of serum PCT,PTX3 and HMGB-1 in the infection group were (2.42±0.39) μg/L,(3.74±0.53)μg/L,(2.07±0.66) μg/L,(3.06±0.75) μg/L,(18.35±2.74) μg/L,and (26.09±4.16) μg/L at 1d and 3d after operation,which were higher than those in the non-infection group (1.71±0.35) μg/L,(2.29±0.36) μg/L,(1.48±0.52) μg/L,(1.73±0.59) μg/L,(13.04±2.26) μg/L,and (15.75±2.83) μg/L(P<0.05).Receiver operating characteristic curve showed that the area under the curve (AUC) of combined detection of serum PCT,PTX3 and HMGB-1 in predicting postoperative infection in children with open gastrointestinal surgery was the largest (0.989) at 3 days after operation; Multivariate Logistic regression analysis showed that age was an independent protective factor for postoperative infection in children,and Intraoperative blood loss,operation time,serum PCT,PTX3 and HMGB-1 at 1d and 3d after operation were independent risk factors (P < 0.05);  The levels of serum PCT,PTX3 and HMGB-1 in children with moderate to severe infection were  (2.63±0.34) μg/L,(4.12±0.56) μg/L,(2.31±0.69) μg/L,(3.39±0.81) μg/L,(19.86±2.91) μg/L,and (28.84±4.40) μg/L at 1-d and 3-d after operation,which were higher than those in children with mild infection (2.11±0.28) μg/L,(3.19±0.49) μg/L,(1.72±0.60) μg/L,(2.58±0.73) μg/L,(16.15±2.39) μg/L,and (22.09±3.96) μg/L (P<0.05).Conclusion The expression of serum PCT,PTX3 and HMGB-1 in children after open gastrointestinal surgery was significantly increased,and its expression was related to early postoperative infection and the severity of infection,and the combined predictive value of the three was higher,which could provide reference for early infection prediction.

Key words: open gastrointestinal surgery, procalcitonin, pentraxin 3, high mobility group protein B1, infection