【摘要】 目的:揭示脑外伤患者血浆高迁移率族蛋白B1(HMGB1)浓度的变化,探讨其在脑损伤中的作用及对预后的预测价值。方法:收集重型脑外伤患者作为脑外伤组,共112例。收集同期健康体检人群作为正常对照组,共40例。对照组静脉血体检时获得。脑外伤组静脉血在入院时获得。ELISA测定血浆HMGB1浓度。结果:脑外伤后1个月内死亡31例(27.7%)。血浆HMGB1浓度(6.4±2.8)ng/ml显著高于正常对照组(1.2±0.3)nig/ml(P<0.001)。入院时GCS评分与血浆HMGB1浓度呈显著负相关(r=-0.425,P<0.01)。Logistic回归分析显示,入院时血浆HMGB1浓度(OR=1.117,95%CI=1.056～1.269,P<0.01)是脑外伤后1个月内死亡的危险因素。ROC曲线分析显示血浆HMGB1浓度预测脑外伤后1个月内死亡有显著预测价值(曲线下面积=0.776,95%CI=0.712～0.869,P<0.001),且判定血浆HMGB1浓度7.2ng/ml,对预测脑外伤后1个月内死亡有71.0%的灵敏度和61.7%的特异度。结论:脑外伤后血浆HMGB1浓度升高,可能参与脑损伤的炎症反应,临床检测这个指标有助于早期判断脑外伤患者的预后。更多还原

【Abstract】 Objective To study the clinical and prognostic significance of determination of plasma high mobility group box 1 protein (HMGB1) levels in patients with acute brain injury.Methods Plasma HMBG1 levels were determined with ELISA in 112 patients with acute brain injury and 40 controls.Results In the 31 patients died within 1 month after injury,the plasma HMGB1 levels (mean 6.4±28ng/ml) were significantly higher those(1.2±0.3ng/ml) in the controls(P<0.001).At admission,the Glascow coma score was significantly negatively correlated with the plasma HMGB1 concentration(r = 0.425,P<0.001).Multivariate analysis selected plasma HMGB1 level as an independente predictor for mortality within one month in patients with acute brain injury(OR = 1. 117,95%CI = 1.056～1.269,P<0.01).ROC curve analysis showed significant predictor value of plasma HMGB1 level for mortality within one month(AUC =0.776,95%CI=0.712～0.869,P<0.001),with cut off 7.2ng/ml,sensitivity 71%and specificity 61.7%.Conclusion Elevation of plasma HMGB1 levels in patients with acute brain injury would intensify the inflammatory reaction and was of prognostic importance.更多还原