Study on the influencing factors and mechanism of Hirschsprung-associated enterocolitis

ObjectiveTo investigate the influencing factors and mechanism of Hirschsprung-associated enterocolitis(HAEC).

MethodsA total of 114 cases of HAEC patients treated with radical megacolon were collected.The influencing factors of HAEC were analyzed using logistic regression analysis method.The expression levels of Lipopolysaccharide(LPS) and tight junction protein(ZO-1) in the dilated segment tissue of children with Hirschsprung's disease(HSCR) were detected using ELISA assay, and the correlations between which and HAEC were analyzed using the Pearson correlation analysis method.

ResultsAmong 114 children patients, 69 cases without HAEC and 45 cases with HAEC(37.82%) were identified, and the preoperative HAEC in 23 patients(20.17%), postoperative HAEC in 10 patients(8.77%) and preoperative and postoperative HAEC in 12 patients(10.53%) with HAEC were found.The differences of the gestational week and type of HSCR were not statistically significant(P>0.05), while the exclusive breastfeeding was a protective factor for HAEC and preoperative HAEC(P < 0.01 and P < 0.05).The expression level of LPS in the dilated segment tissue of preoperative HAEC group were higher than that of non-HAEC group(P < 0.01), the expression level of ZO-1 was low, and the LPS expression level was negatively correlated with ZO-1(r=0.361, P < 0.01).The expression level of LPS in dilated segment tissue of the exclusive breastfeeding group was lower than that of the non-proprietary breastfeeding group(P < 0.01).

ConclusionsThe exclusive breastfeeding is a protective factor for the pathogenesis of HAEC.Breast milk may reduce the risk of HAEC by decreasing the expression level of LPS to further affect the expression of related tight junction proteins.