高迁移率蛋白-1对多发伤后全身炎症反应综合征的预警价值

目的 探讨血清HNGB-1水平对多发伤后全身炎症反应综合征(SIRS)患者病情发生发展的预警价值.方法 将60例入住上海市东方医院急诊创伤中心的多发伤后SIRS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,选择健康体检者20例作为对照组.检测试验组入院24 h、第3、5、7天和对照组血清HMGB-1浓度,并进行APACHE Ⅱ评分.结果 SIRS组入院后HNGB-1浓度进行性上升,各时间点浓度均明显高于对照组(P<0.01);NODS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).MODS组的APACHEⅡ评分明显高于非MODS组(P<0.01),死亡组的APACHEⅡ评分明显高于存活组(P<0.01).在SIRS患者中,HNGB1浓度与APACHEⅡ评分呈正相关(r=0.7938,P<0.05).结论 HNGB-1作为脓毒症的重要促炎细胞因子,可能参与了多发伤后SIPS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.

The relationship between high-mobility group box-1 protein and the prognosis of patients with systemic inflammatory response syndrome after multiple trauma

Objective To observe the relationship between high-mobility group box-1 protein HMGB-1 andthe prognosis of systemic inflammatory response syndrome (SIRS) patients after multiple trauma. Method Sixtypatients with SIRS after multiple trauma in the emergency trauma center were divided into multiple organ dysfunc-tion syndrome (MODS) group and non-MODS group according to the MODS diagnostic criteria, and were followedup for 28 days and then assigned to survival group and fatal group, respectively. Another 20 healthy people wereera-oiled in the conrtol group. The levels of HMGB-1 were measured by ELISA at 24 hours, 3 days, 5 days and 7days after admission. APACHE Ⅱ scores were calculated. Results The concentrations of HMGB- 1 in the patientswith SIRS after trauma at every time point were higher than those in control group (P<0.01). The concentrationsof HMGB-1 and APACHEⅡ scores in the MODS group and the fatal group were higher than those in non-MODSgroup and the survival group (P<0.05 and P<0.01 separately). There was positive correlation between theconcentrations of HMGB-1 and APACHE Ⅱ scores (r=0.7938, P<0.05). Conclusions As an importantpro-inflammatory cytokine in sepsis, HMGB-1 may play a role in the development of SIRS after multiple trauma andcan be used to assess the severity of illness and prognosis.