[1]胡 泽,李 艳,邵 军.腹股沟疝患者血清高迁移率族蛋白B1和Toll样受体4水平变化及检测意义[J].陕西医学杂志,2025,54(2):253-257,262.[doi:DOI:10.3969/j.issn.1000-7377.2025.02.023]
　HU Ze,LI Yan,SHAO Jun.Changes and detection significance of serum high mobility group protein B1 and Toll-like receptor 4 in patients with inguinal hernia[J].,2025,54(2):253-257,262.[doi:DOI:10.3969/j.issn.1000-7377.2025.02.023]
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腹股沟疝患者血清高迁移率族蛋白B1和Toll样受体4水平变化及检测意义
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年2期
页码:
253-257,262
栏目:
临床检验
出版日期:
2025-02-05

文章信息/Info

Title:
Changes and detection significance of serum high mobility group protein B1 and Toll-like receptor 4 in patients with inguinal hernia
作者:
胡 泽; 李 艳; 邵 军
(唐山市中医医院肛肠科,河北 唐山 063000)
Author(s):
HU Ze; LI Yan; SHAO Jun
(Department of Anorectum,Tangshan Traditional Chinese Medicine Hospital,Tangshan 063000,China)
关键词:
腹股沟疝;  高迁移率族蛋白B1;  Toll样受体4;  腹腔镜下全腹膜外疝修补术;  复发;  预测价值
Keywords:
Inguinal hernia;  High mobility group protein B1;  Toll-like receptor 4;  Laparoscopic totally extraperitoneal prosthesis;  Recurrence;  Predictive value
分类号:
R 256.45
DOI:
DOI:10.3969/j.issn.1000-7377.2025.02.023
文献标志码:
A
摘要:
目的:探讨腹股沟疝患者血清高迁移率族蛋白B1(HMGB1)和Toll样受体4(TLR4)水平变化及检测意义。方法:选取接受腹腔镜下全腹膜外疝修补术(TEP)的腹股沟疝患者256例为疾病组,另选取同期体检健康者213例为对照组。比较对照组和疾病组血清HMGB1和TLR4水平。术后进行随访,根据腹腔镜下TEP术后1年内复发情况将患者分为复发组(24例)和未复发组(232例)。比较复发组和未复发组临床资料及不同时间点血清HMGB1和TLR4水平。采用多因素Logistic回归分析腹股沟疝患者腹腔镜下TEP术后1年复发的影响因素。绘制受试者工作特征(ROC)曲线分析血清HMGB1和TLR4对腹股沟疝患者腹腔镜下TEP术后1年复发的预测价值。结果:疾病组术前血清HMGB1和TLR4水平高于对照组(均P<0.05)。术后7 d,两组血清HMGB1和TLR4水平较术前降低,且未复发组低于复发组(均P<0.05)。复发组合并糖尿病、高血压、疝环重度粘连、术后发生并发症、术后过早下床活动以及手术医生经验<3年的比例高于未复发组(均P<0.05)。术后7 d血清HMGB1、术后7 d血清TLR4、合并高血压、疝环粘连程度、术后并发症、手术医生经验为腹股沟疝患者腹腔镜下TEP术后1年复发的独立影响因素(均P<0.05)。术后7 d血清HMGB1、TLR4两者联合预测腹股沟疝患者腹腔镜下TEP术后1年复发的曲线下面积(AUC)高于单独预测的AUC(均P<0.05)。结论:腹股沟疝患者血清HMGB1和TLR4水平较高,两者联合对腹股沟疝患者腹腔镜下TEP术后1年复发具有一定预测价值。
Abstract:
Objective:To investigate the changes in serum levels of high mobility group protein B1(HMGB1)and Toll-like receptor 4(TLR4)in patients with inguinal hernia and the significance of their detection.Methods:A total of 256 patients with inguinal hernia who underwent laparoscopic totally extraperitoneal prosthesis(TEP)were selected as the disease group,and 213 healthy individuals from the same period were selected as the control group.Serum levels of HMGB1 and TLR4 were compared between the control group and disease group.Patients were followed up after surgery,and based on the recurrence within one year after laparoscopic TEP,they were divided into recurrence group(24 cases)and non-recurrence group(232 cases).Clinical data and serum levels of HMGB1 and TLR4 at different time points were compared between the recurrence and non-recurrence groups.Multifactorial Logistic regression analysis was used to analyze the influencing factors of recurrence within one year after laparoscopic TEP in patients with inguinal hernia.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum HMGB1 and TLR4 for recurrence within one year after laparoscopic TEP in patients with inguinal hernia.Results:Preoperative serum levels of HMGB1 and TLR4 in the disease group were higher than those in the control group(all P<0.05).At 7 days after operation,the serum levels of HMGB1 and TLR4 in the two groups were lower than those before operation,and those in the non-recurrence group were lower than those in the recurrence group(all P<0.05).The proportion of patients with comorbid diabetes,hypertension,severe adhesion of the hernia ring,postoperative complications,early postoperative ambulation,and surgeon experience of less than 3 years in the recurrence group was higher than in the non-recurrence group(all P<0.05).Serum HMGB1 at 7 days postoperatively,serum TLR4 at 7 days postoperatively,comorbid hypertension,degree of adhesion of the hernia ring,postoperative complications,and surgeon experience were independent influencing factors for recurrence within one year after laparoscopic TEP in patients with inguinal hernia(all P<0.05).The combined predictive area under the curve(AUC)of serum HMGB1 and TLR4 for recurrence within one year after laparoscopic TEP in patients with inguinal hernia was higher than that of individual predictions(all P<0.05).Conclusion:Patients with inguinal hernia have higher serum levels of HMGB1 and TLR4,and their combination has certain predictive value for recurrence within one year after laparoscopic TEP.

参考文献/References:

[1] BOSMANS I,DE-BOE V,WISSING K M,et al.A preventable cause of transplant hydroureteronephrosis:Inguinal herniation of the transplant ureter:Case report and review of the literature[J].Acta Chir Belg,2021,121(5):340-345.
[2] ARSLAN M,AKKURT G,AKKURT B,et al.Investigation of the clinical efficacy of thiol-disulfide homeostasis,delta neutrophil index,and ischemia-modified albumin in cases of incarcerated and strangulated hernia[J].Ulus Travma Acil Cerrahi Derg,2023,29(9):987-995.
[3] UMEDA K,TAKEDA T,HAKOZAKI K,et al.A low subcutaneous fat mass is a risk factor for the development of inguinal hernia after radical prostatectomy[J].Langenbecks Arch Surg,2022,407(7):3107-3112.
[4] WANG D C,FU J W,JIANG T,et al.Metaanalysis of single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair[J].Updates Surg,2023,75(8):2133-2145.
[5] 包小平,马元勇,沈钧华,等.弓状线变异在腹腔镜全腹膜外疝修补术中的解剖分析及临床研究[J].陕西医学杂志,2022,51(7):807-810.
[6] HALADU N,ALABI A,BRAZZELLI M,et al.Open versus laparoscopic repair of inguinal hernia:An overview of systematic reviews of randomised controlled trials[J].Surg Endosc,2022,36(7):4685-4700.
[7] 蔡玉茹,郭婧,杨红玉,等.早期宫颈癌(Ⅰa1～Ⅱa2)术后TLR4、HMGB1和RAGE水平对24个月肿瘤复发的预测价值[J].河北医药,2022,44(10):1450-1454,1459.
[8] CIESIELSKA A,MATYJEK M,KWIATKOWSKA K.TLR4 and CD14 trafficking and its influence on LPS-induced pro-inflammatory signaling[J].Cell Mol Life Sci,2021,78(4):1233-1261.
[9] 中华医学会外科学分会疝与腹壁外科学组,中国医师协会外科医师分会疝和腹壁外科医师委员会.成人腹股沟疝诊断和治疗指南(2018年版)[J].中华胃肠外科杂志,2018,21(7):721-724.
[10] BODILSEN A,BRANDSBORG S,FRIIS-ANDERSEN H.Recurrence and complications after sliding inguinal hernia repair[J].Hernia,2022,26(4):1047-1052.
[11] COWAN B,KVALE M,YIN J,et al.Risk factors for inguinal hernia repair among US adults[J].Hernia,2023,27(6):1507-1514.
[12] 王海波,何大勇.老年腹股沟疝患者微创修补术后复发的影响因素分析及预防建议[J].中国现代普通外科进展,2023,26(2):131-135.
[13] FU Y,XIANG Y,WANG Y,et al.The STAT1/HMGB1/NF-κB pathway in chronic inflammation and kidney injury after cisplatin exposure[J].Theranostics,2023,13(9):2757-2773.
[14] 王娟,廖焕金,李延宁,等.RSV感染气液相界面培养人支气管上皮细胞模型的建立及其对HMGB1和pMLKL表达的影响[J].检验医学,2022,37(2):177-182.
[15] 杨阳,田丹丹,樊晓慧.电针缓解完全弗氏佐剂诱导的炎性痛及对前扣带皮层脑区HMGB1/TLR4信号通路的调控作用[J].陕西中医,2022,43(1):3-7,37.
[16] 郭云瑞,杨皓,张业才,等.腹部区域阻滞联合静脉镇痛对老年患者术后并发症的影响[J].昆明医科大学学报,2022,43(12):117-124.
[17] LARSEN N K,REILLY M J,THANKAM F G,et al.Novel understanding of high mobility group box-1 in the immunopathogenesis of incisional hernias[J].Expert Rev Clin Immunol,2019,15(7):791-800.
[18] OLONA A,HATELEY C,MURALIDHARAN S,et al.Sphingolipid metabolism during Toll-like receptor 4(TLR4)-mediated macrophage activation[J].Br J Pharmacol,2021,178(23):4575-4587.
[19] CHEN S N,TAN Y,XIAO X C,et al.Deletion of TLR4 attenuates lipopolysaccharide-induced acute liver injury by inhibiting inflammation and apoptosis[J].Acta Pharmacol Sin,2021,42(10):1610-1619.
[20] 刘景鸿,万云,刘晓龙,等.白藜芦醇调控TLR4/NF-κB信号通路对溃疡性结肠炎大鼠炎症反应的影响[J].中国老年学杂志,2023,43(24):6078-6082.
[21] SEMKOVYCH Y,DMYTRIIEV D.Elevated serum TLR4 level as a potential marker for postsurgical chronic pain in pediatric patients with different approaches to analgesia[J].Front Med(Lausanne),2022,9(1):897533.
[22] 曾润生,梁玉鹃,蔡承哲,等.外周血TLR4、CysC联合检测对冠心病患者PCI术后1年内ISR发生的预测价值[J].吉林医学,2023,44(11):3063-3067.
[23] GAO Y,GAO Y,NIU Z,et al.CCCTC-binding factor-mediated microRNA-340-5p suppression aggravates myocardial injury in rats with severe acute pancreatitis through activation of the HMGB1/TLR4 axis[J].Immunopharmacol Immunotoxicol,2022,44(3):306-315.
[24] LI X,YANG X,LU H,et al.Calycosin attenuates the inflammatory damage of microglia induced by oxygen and glucose deprivation through the HMGB1/TLR4/NF-κB signaling pathway[J].Acta Biochim Biophys Sin(Shanghai),2023,55(9):1415-1424.
[25] 施春娟,钟宝英.老年患者腹股沟疝微创修补术后复发的影响因素分析[J].浙江创伤外科,2023,28(9):1712-1715.

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备注/Memo

备注/Memo:
[基金项目]河北省中医药类科研计划课题(2020381)
更新日期/Last Update: 2025-02-04