高迁移率族蛋白质1在心力衰竭患者血清中表达及意义

目的探讨高迁移率族蛋白质1（high mobility group box 1 protein，HMGBl）在心力衰竭中的致病作用。方法心力衰竭患者42例，按照NYHA心功能分级分组，心功能Ⅱ级组16例，心功能Ⅲ级组14例，心功能Ⅳ级组12例，心功能正常者20例为对照组。采用酶联免疫法测定HMGBl、脑钠肽前体（pro—brain natriuretic peptide，pro—BNP）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）和高敏c反应蛋白（highsen sitivity C—reactive protein，hs—CRP）。超声检查测定心功能。结果心力衰竭患者各组HMGBl、pro-BNP和TNF-α均较对照组明显升高（P〈O．05），随心力衰竭分级加重，上述指标水平升高更明显，两两比较差异均有统计学意义（P〈0．05）；血清HMGBl与pro—BNP、TNF-α、hs—CRP、左室射血分数水平呈正相关（r=0．630，P=0．043；r=0．560，P=0．046；r=0．540，P=0．048；r=0．670，P=0．041）。结论HMGBl水平升高对心力衰竭的诊断及病情评估有重要价值。

Expression and clinical significance of high mobility group box 1 protein in the serum of patients with heart failure

Objective To investigate the pathogenic role of high mobility group box 1 protein （HMGB1） in heart failure. Methods According to the class of NYHA cardiac function, 42 patients were divided into class II group （n= 16）, class III group （n=14） and class IV group （n=12）. Another 20 subjects were as normal controls （control group）. All these groups were determined HMGB1, pro-brain natriuretic peptide （pro-BNP）, tumor necrosis factor-α （TNF-α） and high sensitivity C-reactive protein （hs-CRP） by ELISA technique. The cardiac function was detected by echocardiography. Results The levels of HMGB1, pro-BNP and TNF-α were significantly higher in patients with heart failure than those in control group （P〈0.05）, and increased with the worsening of cardiac function, showing significant differences in multiple comparison （P〈0.05）. HMGB1 was positively correlated with levels of pro-BNP, TNF-a, hs-CRP and left ventricular ejection fraction （r=0. 630, P=0. 043; r=0. 560, P=0. 046; r=0. 540, P=0. 048; r=0. 670, P=0. 041）. Conclusions The increased HMGB1 level has an important value to the diagnosis and disease assessment of heart failure.