血浆高迁移率族蛋白B1浓度与脑外伤预后的相关性分析

目的：揭示脑外伤患者血浆高迁移率族蛋白B1（HMGBl）浓度，分析其与预后的相关性。方法：收集重型脑外伤患者118例和同期健康体检正常者50例。健康体检正常者静脉血体检时获得，脑外伤患者静脉血在入院时获得。ELISA测定血浆HMGBl浓度，统计分析其与预后的相关性。结果：￡检验显示，脑外伤患者血浆HMGBl浓度（9．4±2．3）ng／ml显著高于健康体检正常者（1．6±0．3）ng／ml（t=9．583，P〈0．01）。多因素分析显示，血浆HMGBI浓度是脑外伤1周内死亡（OR=1．309，95％CI=1．197-1．743，P〈0．01）、1年内死亡（OR=1．476，95％CI=1．208-1．796，P〈0．01）和1年内神经功能预后不良（格拉斯哥预后评分1-3分）（OR=1．419，95％CI=1．218-1．697，P〈0．01）的独立危险因素，ROC曲线分析显示，血浆HMGBl浓度可预测脑外伤1周内死亡（曲线下面积=0．865，95％CI=0．824-0．901，P〈0．01）、1年内死亡（曲线下面积=0．891，95％CI=0．835-0．934，P〈0．01）和1年内神经功能预后不良（曲线下面积=0．876，95％CI=0.832-0．925，P〈0．01）。结论：脑外伤后血浆HMGBl浓度显著升高，临床检测这些指标有助于早期判断脑外伤预后。

Correlative Analysis of Plasma High Mobility Group Box 1 Protein Concentration with Prognosis of Patients with Traumatic Brain Injury

Objective To observe plasma high mobility group box 1 protein level in the patients with traumatic brain injury and evaluate its correlation with disease outcome.Methods 118 consecutive patients with acute severe traumatic brain injury and 50 ageand sex-matched healthy controls were enrolled into this study simultaneously.Plasma samples were obtained on entry in healthy controls and on admission in the patients.Its concentration was measured by enzyme-linked immunosorbent assay.Results Plasma high mobility group box 1 protein level in the patients(9.4±2.3 ) ng/ml was substantially higher than that of healthy controls(1.6±0.3 ) ng/ml(P <0.01) using T test.A multivariate analyses selected plasma high mobility group box 1 protein level as an independent predictor for 1-week mortality(OR = 1.309,95%CI = 1.197～1.743,P<0.01),1 -year mortality(OR = 1.476,95%CI = 1.208～1.796,P <0.01) and 1-year unfavorable outcome(OR = 1.419,95%CI = 1.218～1.697,P <0.01).A receiver operating characteristic curve analyses showed that plasma high mobility group box 1 protein level predicted 1 -week mortality(Area under curve = 0.865, 95%CI =0.824～0.901,P<0.01),1 -year mortality(Area under curve =0.891,95%CI = 0.835～0.934,P<0.01) and 1-year unfavorable outcome(Area under curve = 0.876,95%CI = 0.832～0.925,P <0.01)obviously.Conclusion Increased plasma high mobility group box 1 protein level was found after traumatic brain injury,in association with a poor clinical outcome.