血清高迁移率蛋白B1检测在急性阑尾炎诊断中的应用  

Application of serum high mobility group box protein-1 level detection in diagnosis of acute appendicitis

作　　者：张希儒 张广文 杨栋文 李成利 杨香玲 

机构地区：[1]甘肃省临洮县新添中心卫生院外科,甘肃临洮730516 [2]甘肃省临洮县人民医院骨一科,甘肃临洮730500 [3]甘肃省临洮县中铺中心卫生院外科,甘肃临洮730512 [4]甘肃省临洮县新添中心卫生院检验科,甘肃临洮730516

出　　处：《中国普通外科杂志》2012年第8期992-995,共4页China Journal of General Surgery

基　　金：国家科技计划课题项目(2008BAI65B00);国家科技支撑计划项目(2008BAI65B17)

摘　　要：目的:探讨急性阑尾炎患者血清中高迁移率蛋白B1(HMGB1)水平及其对急性阑尾炎诊断的意义。方法:采用ELISA定量试剂盒检测40例健康体检者(A组)和129例拟诊为急性阑尾炎患者血清HMGB1水平,同时检测白细胞(WBC)和C反应蛋白(CRP)水平。根据手术和病理结果将129例拟诊患者分为:B组(非阑尾炎15例),C组(急性单纯性阑尾炎63例),D组(急性化脓性、坏疽性、穿孔性急性阑尾炎及阑尾周围脓肿51例),比较上述指标在各组中的差异并采用受试者工作曲线(ROC)分析各指标对急性阑尾炎的诊断效率。结果:与A,B组比较,C,D组患者WBC,血清CRP及HMGB1均明显升高,差异均有统计学意义(均P<0.05),且D组各项指标均明显高于C组(均P<0.05);ROC曲线分析显示,WBC,CRP和HMGB1的曲线下面积(AUC)分别为0.729,0.811和0.850,HMGB1的诊断效率最高(均P<0.05)。结论:急性阑尾炎患者血清HMGB1水平明显升高,血清HMGB1水平可望作为评价急性阑尾炎病变和炎症反应程度的辅助指标。Objective： To investigate the serum level of serum high mobility group protein i （HMGB 1 in patients with acute appendicitis and its diagnostic significance. Methods： The serum HMGB1 levels of 40 sub）ects undergoing health maintenance examination （group A） and 129 suspected acute appendicitis patients were detected by using quantitative ELISA kit, and their white blood cell （WBC） count and C-reactive protein （CRP） level were also determined. According to the surgicalfindings and postoperative pathological results, the 129 suspected cases were distinguished into group B （15 cases without appendicitis）, group C （63 cases of simple acute appendicitis） and group D （51 cases of acute suppurative, gangrenous, perforated appendicitis or periappendiceal abscess）. The differences in above mentioned indexes among the groups were compared and the receiver operating characteristic （ROC） curve analysis was performed to evaluate the diagnostic efficiency of each index for acute appendicitis. Results： The WBC count, serum level of HMGB 1 and CRP markedly increased in group C and group D compared with group A or group B, and all differences had statistical significance （all P〈0.05）; further, all the values of the indexes in group D were significantly higher than those in group C （all P〈0.05）. ROC curve analysis showed that area under the curve （AUC） ofWBC, CRP and HMGB1 were 0.729, 0.811 and 0.850 respectively, and HMGB1 had the highest diagnostic efficiency （both P〈0.0S）. Conclusion： Patients with acute appendicitis have a pronounced elevation of serum HMGB1 level, thus it could be reasonably expected to become an important assistant diagnostic index for acute appendicitis and severity of this disease.

关 键 词：阑尾炎/诊断 实验室技术和方法 高迁移率蛋白B1 C反应蛋白 

分 类 号：R656.8[医药卫生—外科学]