慢性阻塞性肺疾病血清高迁移率蛋白1检测及临床意义

目的探讨高迁移率蛋白1（HMGB1）在COPD发病机制及其在判断COPD急性加重期（AEc0PD）患者病情严重程度的作用。方法选择AECOPD患者49例作为AECOPD组，依据肺功能将其分为2个亚组：轻一中度组24例，重一极重度组25例；人选患者进行抗感染、吸氧、解痉平喘、止咳等对症治疗，在急性发作症状及体征好转后作为COPD缓解期组；同期门诊健康体检者25例作为对照组。采用酶联免疫吸附双抗体夹心法测定各组受试者血清HMGB1的水平，并对AECOPD组患者行肺功能检测（包括FEV1％pred，FEV1／FVC）。结果AECOPD患者血清HMGBl水平高于cOPD缓解期组患者（P〈O．05），COPD缓解期组患者血清HMGB1水平高于正常对照组（P〈0．05）。重一极重度组AECOPD患者血清HMGB1水平高于轻一中度组AECOPD患者（P〈0．05）；轻一中度组AECOPD患者血清HMGB1水平高于正常对照组（P〈O．05）。AECOPD患者血清HMGB1含量随FEV，％pred降低而增高，呈负相关（r=-0．64）。结论HMGB1参与了COPD气道炎症的发生、发展。血清HMGB1有望成为反映AECOPD病情严重程度的一个血清学指标。

Measure and clinic significance of high mobility group protein box-1 in chronic obstructive pulmonary disease

Objective Investigate the function of high-mobility group box 1 （HMGB1） in chronic obstructive pulmonary disease （COPD） pathogenesis and in judging the severity of AECOPD patients＇ condition. Methods Forty-nine cases of AECOPD patients as the AECOPD group,and separate them into two sub-groups： 24 cases for mild-moderate group, 25 cases for severe-profound group. Conduct symptomatic treatments （anti infection,oxygen inhalation, spasmolytic and asthma relieving,antitussive treatment,etc. ） on patients,and select those whose acute attack sign and symptom improve to be COPD remission group. The 25 cases of simultaneous outpatients who are healthy in physical examination as control group. When finishing the collection of cases, measure and define the H MGB1 level of the subjects through enzyme-linked immunosorbent assay. And test the pulmonary function of AECOPD patients （test the percentage of FEV1 in predicted value, FEV1/FVC）. Results The levels of serum HMGB1 in AECOPD groups are higher than COPD groups of stable period （ P 〈0.05）. The levels of serum HMGB1 in the COPD groups of stable period are higher than control groups （ P〈0.05）. The levels of serum HMGB1 in weight-very svere of AECOPD groups are higher than COPD groups of light-moderate （ P 〈 0.05）. The levels of serum HMGB1 in the COPD groups of stable period are higher than control groups （ P %0.05）. The serum concentration of HMGB1 and FEV1% predicted are negative correlation in patient with AECOPD （r = -0.64）. Conclusions HMGB1 take part in the airway inflammation and development of COPD. The HMGB1 can be a biomarker of the severity of COPD.