| 李晓博,姜 海,薛英森,赵国龙,同毓龙.四肢手足对称多指趾发育的基因特征与显微镜手术预后的相关性[J].,2021,(4):772-775 |
| 四肢手足对称多指趾发育的基因特征与显微镜手术预后的相关性 |
| Correlation between Genetic Characteristics of Symmetrical Polydactyly Development of Limbs, Hands, Feet and Prognosis of Microsurgery |
| 投稿时间：2020-04-26 修订日期：2020-05-22 |
| DOI：10.13241/j.cnki.pmb.2021.04.037 |
| 中文关键词: 四肢手足对称多指趾 HOXD13基因 基因突变 显微手术 预后 |
| 英文关键词: Symmetrical multi-finger toe of limbs, hands, feet HOXD13 gene Gene mutation Microsurgery Prognosis |
| 基金项目:陕西省卫生健康委科研基金项目（2018D038） |
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| 中文摘要: |
| 摘要 目的：探讨四肢手足对称多指趾发育的基因特征与显微镜手术预后的相关性。方法：2016年2月至2020年1月选择在本院诊治的四肢手足对称多指趾患儿110例作为研究对象，所有患儿都给予显微手术治疗，记录预后情况。采用PCR方法检测HOXD13基因突变情况并进行相关性分析。结果：在110例患儿中，HOXD13基因突变45例，突变率为40.9 %。突变组的性别、年龄、体重指数、血压、Wassel分型等与非突变组对比差异无统计学意义(P>0.05)。术后3个月突变组的疗效优良率为77.8 %，显著低于非突变组的96.9 %(P<0.05)。术后3个月突变组的肌腱粘连、切口感染、皮肤坏死、指趾间关节偏斜等并发症发生率为28.9 %，显著高于非突变组的3.1 %(P<0.05)。Pearson分析显示HOXD13基因突变与预后疗效、并发症等都存在相关性(P<0.05)；多因素logistic回归分析分析显示HOXD13基因突变也是影响患儿预后疗效、并发症的主要因素(P<0.05)。结论：四肢手足对称多指趾患儿多伴随有HOXD13基因突变，显微手术具有很好的可行性，HOXD13基因突变与显微手术预后有显著相关性。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the correlation between the genetic characteristics of the development of symmetrical polydactyly of the limbs, hands, feet and the prognosis of microsurgery. Methods: From February 2016 to January 2020, 110 cases of children with symmetrical polydactyly development of limbs, hands, feet were selected as the research subjects. All children were treated with microsurgery and were to record the prognosis. The PCR method were used to detect the mutation of HOXD13 gene and the correlation were analyzed. Results: There were 45 cases were mutated with HOXD13 gene in the 110 children, and the mutation rates were 40.9 %. There were no significant difference in gender, age, body mass index, blood pressure, and Wassel typing compared between the mutant group and the non-mutant group (P>0.05). The excellent and good efficacy rates of the mutant group at 3 months after operation were 77.8 %, which were significantly lower than the 96.9 % of the non-mutant group (P<0.05). The incidence of complications such as tendon adhesion, incision infection, skin necrosis, and interphalangeal joint deflection in the mutant group at 3 months after operation were 28.9 %, which were significantly higher than the non-mutant group at 3.1 % (P<0.05). Pearson analysis showed that there were correlation between HOXD13 gene mutation and prognosis efficacy, complications (P<0.05). Multivariate logistic regression analysis showed that HOXD13 gene mutation were also the main factor affecting the prognosis efficacy and complications of patients (P<0.05). Conclusion: Children with symmetric multi-finger toes in the hands, feet, and feet are often accompanied by mutations in the HOXD13 gene. Microsurgery are very feasible. The mutations in the HOXD13 gene are significantly associated with the prognosis of microsurgery. |
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