急性胰腺炎患者血清高迁移率族蛋白1水平的变化及意义

目的观察急性胰腺炎（AP）患者血清高迁移率族蛋白1（HMGBl）水平的变化，探讨其与疾病严重程度的相关性及临床意义。方法选择50例AP患者，按病情轻、重分2组，重症急性胰腺炎（SAP）24例，轻症急性胰腺炎（MAP）26例；选择同期年龄及性别相匹配的正常对照组20例为研究对象。正常对照组检测血清HMGBl水平一次，病例组人院后第1、2、3天分别检测HMGBl含量，并对患者不同时段进行APACHEⅡ评分，评估其病情严重程度与血清HMGBl水平变化病死率的关系。结果AP患者血清HMGBl水平显著高于正常对照组（P〈0．01）；SAP组血清HMGBl水平在入院后前3d均显著高于MAP组（P〈0．05），MAP组入院后第3天血清HMGBl水平低于入院后第1、2天（P≤0．01），SAP组在入院后第2天血清HMGBl水平高于第1天（P〈0．01），入院后第3天血清HMGBl水平仍维持较高水平（P〈0．05）。AP患者血清HMGBl水平与APACHEII的评分呈正相关（P〈0．01）。AP死亡者血清HMGBl水平显著高于存活者（P〈0．01）。结论AP患者血清HMGBl水平与APACHEII评分、28d病死率密切相关，其HMGBl指标对AP疾病的诊断、病情程度及预后具有指导意义。

A study on change of serum levels of HMGB1 and its significance in patients with acute pancreatitis

Objective The study was performed to observe the change of serum levels of high mob- ility group protein box 1 （HMGBl） in patients with acute pancreatitis （AP） and to determine its relation- ship to the severity of AP in order to reveal its clinical significance. Methods The serum levels of HMGBlwere measured in 50 patients with AP including 24 cases of severe acute pancreatitis （SAP） and 26 cases of mild acute pancreatitis （MAP） in first three days after admission. The serum levels of HMGBl were also detected in 20 healthy volunteers. Furthermore, clinical data of patients was collected and APACHE Ⅱ scores were calculated at the time when serum HMGBl levels were detected to assess the severity of the dis-ease. The 28 day mortality of AP patients was also observed. Then, the relationship between serum HMGBl levels and the severity of AP was analyzed. Conclusions Serum levels of HMGBl in patients with AP were significantly positively correlated with APACHE Ⅱ scores. Serum levels of HMGBl in patients with AP Were significantly positively correlated with the 28 day mortality. HMGBI could be used as an effective indicator to evaluate severity of AP.