HMGB1对老年急性心力衰竭患者预后的评估价值

目的 探讨血清高迁移率族蛋白B1（high mobility group box-1，HMGB1）水平在老年急性心力衰竭患者预后评估中的价值。方法 选取2016年1月~2016年12月期间在信阳市第一人民医院住院且年龄>65岁的急性心力衰竭患者96例。入院时即抽取静脉血行HMGB1、N末端B型脑钠肽前体（NT-proBNP）、生化、血常规等检查。并对入选的患者随访1年，观察1年内患者终点不良事件的发生情况，并确定其与HMGB1水平之间的关系。结果 96例急性心力衰竭患者中，发生终点不良事件组患者HMGB1水平明显高于未发生终点不良事件组。单因素和多因素回归分析结果显示，年龄、NT-proBNP、射血分数以及血清HMGB1水平与急性心衰患者1年内的全因病死率相关。ROC曲线分析表明，与年龄、NT-proBNP、射血分数比较，HMGB1水平对急性心力衰竭的预后具有更好的评估价值。Kaplan-Meier生存分析进一步证实血清HMGB1水平较高的患者发生终点不良事件的可能性更大。结论 发生心血管终点不良事件的急性心力衰竭患者的HMGB1水平明显高于未发生终点不良事件者，表明HMGB1可以评估急性心力衰竭患者的预后。

Predicting Value of Serum HMGB1 on Prognosis in Elderly Patients with Acute Heart Failure

Objective To evaluate the prognostic value of plasma levels of high mobility group box-1 (HMGB1) in patients with acute heart failure (AHF). Methods Total of 96 patients clinically diagnosed with AHF were enrolled in this study. Serum HMGB1 levels were determined by enzyme-linked immunosorbent assay. Follow-up was performed l year after acute attack.We defined the end of observation as any causes of death. Results Serum HMGB1 was significantly higher in AHF patients who expired in the one year follow-up period compared to those who survived. Univariate logistic regression analysis yielded 17 variables that were associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 4 variables including age, NT-proBNP, LVEF, and serum HMGB1 level associated with mortality. ROC curve analysis showed that age, NT-proBNP and LVEF displayed poor prognostic value for AHF compared to HMGB1 level. Kaplan-Meier survival analysis confirmed that patients with higher serum HMGB1 levels had significantly higher mortality. Conclusion The elevation of HMGB1 has independent predictive value to the prognosis of AHF.