急性肺损伤患者高迁移率蛋白-1的变化及临床意义

目的 初步探讨高迁移率蛋白-1(HMGB-1)在急性肺损伤(ALI)发病机制中的作用及临床测定价值.方法 将48例入住急诊创伤ICU及中心ICU的ALI患者分为多器官功能障碍综合征组(MODS组)和非MODS组、存活组和死亡组,选择在呼吸内科进行支气管镜检查的14例患者作为对照组.检测ALI组患者确诊当天及第3、5、7天和对照组血清HMGB-1浓度,检测对照组和AU组确诊24 h内及第7天BALF中HMGB-1浓度,并进行肺损伤评分.结果 ALI组确诊24 h内BALF中HMGB-1浓度与对照组比较差异无统计学意义(P>0.05),而ALI组第7天BALF中HMGB-J浓度明显高于对照组及确诊24 h内(P均<0.05).ALI组确诊后血清中HMGB-1浓度进行性上升,各时间点数值均明显高于对照组(P<0.01);MODS组和死亡组HMGB-1浓度分别明显高于非MODS组和存活组(P<0.05和P<0.01).在ALl患者中,血清HMGB-1浓度与肺损伤评分呈正相关(r=0.3120,P<0.05),与氧合指数呈正相关(r=0.4132.P<0.01).结论 HMGB-1作为脓毒症的重要促炎细胞因子,可能参与了ALI的发生,并且对这类患者的病情发展、转归有一定的预测作用.

Clinical significance and changes of high-mobility group box-1 in the patients with acute lung injury

Objective To observe the relationship between high-mobility group box-1(HMGB-1) and the pathophysiological effects and the prognosis of acute lung injury (ALI)patients. Methods 48 patients with ALI in the ICU were divided into multiple organ dysfunction syndrome (MODS) group and non-MODS group according to the MODS diagnostic criterions,and were followed up for 28 days and then assigned to survival group and non-survival group respectively. 14 people with the examination of fiberoptic bronchoscopy were enro...