血浆高迁移率族蛋白B1浓度与脑外伤预后的相关性分析  

Correlative Analysis of Plasma High Mobility Group Box 1 Protein Concentration with Prognosis of Patients with Traumatic Brain Injury

作　　者：陈盛[1] 钱松泉[1] 郑旭东[1] 

机构地区：[1]浙江省瑞安市人民医院急诊科,325200

出　　处：《放射免疫学杂志》2012年第2期164-166,共3页Journal of Radioimmanology

摘　　要：目的:揭示脑外伤患者血浆高迁移率族蛋白B1(HMGB1)浓度,分析其与预后的相关性。方法:收集重型脑外伤患者118例和同期健康体检正常者50例。健康体检正常者静脉血体检时获得,脑外伤患者静脉血在入院时获得。ELISA测定血浆HMGB1浓度,统计分析其与预后的相关性。结果:t检验显示,脑外伤患者血浆HMGB1浓度(9.4±2.3)ng/ml显著高于健康体检正常者(1.6±0.3)ng/ml(t=9.583,P<0.01)。多因素分析显示,血浆HMGB1浓度是脑外伤1周内死亡(OR=1.309,95%CI=1.197～1.743,P<0.01)、1年内死亡(OR=1.476,95%CI=1.208～1.796,P<0.01)和1年内神经功能预后不良(格拉斯哥预后评分1～3分)(OR=1.419,95%CI=1.218～1.697,P<0.01)的独立危险因素,ROC曲线分析显示,血浆HMGB1浓度可预测脑外伤1周内死亡(曲线下面积=0.865,95%CI=0.824～0.901,P<0.01)、1年内死亡(曲线下面积=0.891,95%CI=0.835～0.934,P<0.01)和1年内神经功能预后不良(曲线下面积=0.876,95%CI=0.832～0.925,P<0.01)。结论:脑外伤后血浆HMGB1浓度显著升高,临床检测这些指标有助于早期判断脑外伤预后。Objective To observe plasma high mobility group box 1 protein level in the patients with traumatic brain injury and evaluate its correlation with disease outcome. Methods 118 consecutive patients with acute severe traumatic brain injury and 50 age- and sex-matched healthy controls were enrolled into this study simultaneously. Plasma samples were obtained on entry in healthy con- trois and on admission in the patients. Its concentration was measured by enzyme-linked immunosorbent assay. Results Plasma high mobility group box 1 protein level in the patients （9.4±2.3 ） ng/ml was substantially higher than that of healthy controls （ 1.6 ± 0.3 ）ng/ml（ P 〈0.01 ） using T test. A multivariate analyses selected plasma high mobility group box 1 protein level as an independent pre- dictor for 1-week mortality （ OR = 1. 309, 95% CI = 1. 197= 1. 743, P 〈 0.01 ）, 1-year mortality （ OR = 1. 476, 95% CI = 1. 208=1. 796 ,P 〈0.01 ） and 1-year unfavorable outcome（ OR = 1. 419, 95% CI =1. 218 = 1. 697, P 〈0.01 ）. A receiver operating character- istic curve analyses showed that plasma high mobility group box 1 protein level predicted 1-week mortality （ Area under curve = 0.865, 95% CI = 0.824=0.901, P 〈 0.01 ）, 1-year mortality（ Area under curve = 0. 891, 95% CI = 0. 835=0.934, P 〈 0.01 ） and 1-year unfavorable outcome（Area under curve =0. 876, 95%CI =0.832=0.925, P〈0.01）obviously. Conclusion Increased plasma high mobility group box 1 protein level was found after traumatic brain injury, in association with a poor clinical outcome.

关 键 词：高迁移率族蛋白B1 脑外伤 预后 

分 类 号：R651.15[医药卫生—外科学]