急性颅脑损伤患者血清及脑脊液HMGB1的表达及临床意义  

Expression of High Mobility Group Box 1 Protein in Serum and Cerebrospinal Fluid in Acute Craniocerebral Injury Patients and Its Clinical Significance

作　　者：张鲲鹏[1] 刘德昭[2] 

机构地区：[1]南方医科大学附属潮州市中心医院神经外科,广东潮州521021 [2]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《临床医学工程》2012年第2期199-201,共3页Clinical Medicine & Engineering

基　　金：广东省医学科研基金(B2011104);广东省科技计划项目(2011B031800058)

摘　　要：目的探讨颅脑损伤患者血清及脑脊液中高迁移率簇蛋白B1(HMGB1)的表达及预后的关系。方法选择2009年1月至2011年6月在我院就诊的急性颅脑损伤患者80例,入院后并根据Glasgow昏迷评分(GCS)分成三组:轻度组25例(GCS12～15分);中度组31例(GCS9～11分),重度组24例(GCS3～8分)。另外选择同期在我院因退行性椎间盘病变行骨科手术患者25例作为对照组(N组)。颅脑损伤患者出院后3个月,根据格拉斯哥治疗结果分级(GOS)分级评定,分为三组:死亡及植物状态组(GOS1～2级);残废组(GOS3～4级);恢复良好组(GOS5级)。所有患者均采集上肢静脉血及脑脊液,并采用ELISA方法测定其中HMGB1的表达。结果①急性颅脑损伤患者血清、脑脊液中HMGB1水平均比对照组明显增高(P<0.05);血清、脑脊液中HMGB1水平随颅脑损伤GCS评分增加而逐渐增高;②预后不良患者(死亡及植物状态、残废组)血清、脑脊液中HMGB1水平较预后良好者明显增高(P<0.05)。结论急性颅脑损伤患者早期监测血清及脑脊液中HMGB1水平可判断病情的轻重,并且可作为了解病情与转归的参考指标。Objective To investigate the expression of high mobility group box 1 protein in serum and cerebrospinal fluid in acute traumatic brain injury and its clinical significance. Methods 80 patients with acute traumatic brain injury serviced in our hospital from January 2009 to June 2011 were divided into three groups according to Glasgow coma scale （GCS）： mild injury group （GCS 12 - 15, n =25）, moderate injury group （GCS 9 - 11, n =31） and serious injury groups （GCS 3 - 8, n =24）. Another 25 patients with intervertebral disc disorder were recruited as the control group. After 3 months of post-discharge, the patients with brain injury were divided into three group according to the Glasgow outcome scale （GOS） grates： death and vegetative state group （GOS grate 1 - 2）, disable group （GOS grate 3 ~ 4）, good recover group （GOS grate 5）. The cerebrospinal fluid （CSF） and blood samples were collected from all patients to measure the HMGB1 contents in 24 hours after hospitalization. Results （1）In the early stage of traumatic brain injury, the expression of HMGB1 in serum and CSF were significantly higher than patients in the control group （P〈0.05）, and as the GCS score increased, the HMGB1 expression in serum and CSF also increased; （2）The HMGB1 expression in serum and CSF in unfavourable prognosis patients were higher than those in eusemia patients （P〈0.05）. Conclusion Early detection of the HMGB1 in serum and CSF in patients with acute traumatic brain injury can be used as the reference indices for evaluating the status of this disease and judging its prognosis.

关 键 词：急性颅脑损伤 高迁移率簇蛋白B1 血清 脑脊液 炎性反应 

分 类 号：R651.15[医药卫生—外科学]