严重烧伤患者外周血高迁移率族蛋白B-1水平的检测及其临床意义  

Detection of plasma high mobility group box-1 protein in severely burned patients and its clinical significance

作　　者：肖锦华[1] 王亚萍[1] 朱华燕[1] 潘宇红[1] 黄璇[1] 

机构地区：[1]无锡市第三人民医院检验科,江苏无锡214041

出　　处：《中华医院感染学杂志》2012年第16期3459-3461,共3页Chinese Journal of Nosocomiology

摘　　要：目的检测严重烧伤后患者血浆高迁移率族蛋白B-1(HMGB1)水平的变化并探讨其临床意义。方法用酶联免疫吸附试验法检测77例严重烧伤患者血浆HMGB1水平,同步检测肿瘤坏死因子-α(TNF-α)含量,并与30名健康对照组进行比较。结果 77例严重烧伤患者按烧伤面积分为3组,A组31例,烧伤总面积30%～49%,B组25例,烧伤总面积50%～69%,C组21例,烧伤总面积70%～95%;烧伤患者血浆HMGB1及TNF-α水平在A组为(22.15±6.34)ng/ml、(89.26±21.41)pg/ml,B组为(26.24±9.71)ng/ml、(132.45±76.32)pg/ml,C组为(36.45±11.63)ng/ml、(213.61±87.45)pg/ml,对照组为(2.17±1.13)ng/ml、(45.32±13.84)pg/ml,烧伤各组HMGB1及TNF-α水平明显高于对照组(P<0.01);24例特大面积烧伤患者根据预后情况分为生存组和死亡组进行动态观察,两组患者血浆HMGB1水平在伤后第1天即显著升高(P<0.01),在伤后3～21d,死亡组明显高于生存组(P<0.05),而TNF-α含量在伤后第3～7d达高峰,以后逐渐下降,到21d时生存组与死亡组相比已差异无统计学意义。结论严重烧伤后HMGB1的表达异常升高,HMGB1作为重要的晚期炎症介质和TNF-α相互诱生相互作用,参与严重烧伤后全身炎症反应综合征的病理生理过程,动态观察其水平变化有助于烧伤患者病程监测及预后判断。OBJECTIVE To investigate the changes of plasma high mobility group box-1 protein （HMGB1） in severely burned patients and its clinical significance. METHODS The plasma HMGB1 and TNF-α levels were measured by enzyme linked immunosorbent assay（ELISA） simultaneously in all patients and were compared with 30 healthy control subjects. RESULTS Totally 77 burned patients were involved in this study, and they were divided into three＇ burn size groups： 30%--49 % total body surface area（TBSA） burn（group A, n= 31）, 50%- 69% TBSA burn （group B, n=25） and 70%--95% TBSA burn（group C, n=21）. The levels of HMGB1 and TNF-αin group A were （22. 15±6. 34）ng/ml and（89.26±21.41）pg/ml, the levels of HMGB1 and TNF-α in group B were （26.24±9.71）ng/ml and（132.45±76.32）pg/ml,the levels of HMGB1 and TNF-αin group C were （36. 45 ± 11. 63） ng/ml and（213. 61 ± 87. 45） pg/ml, the levels of HMGB1 and TNF-a in control group were （2.17-1-1.13）ng/ml and（45.32±13.84）pg/ml, The levels of HMGB1 and TNF-a in severely burned patients were significantly higher than those in control group （P〈0.01）; 24 patients with TBSA~ 50% were further divided into the survival group and the death group, the plasma HMGB1 levels were markedly elevated on post burn day 1 in all severely burned patients（P%0.01）, and they were significantly higher in the death group than those of the survival group during 3--21 clays after burns（P〈0.05） ;the TNF-α levels in severely burned patients reached the peak value 3- 7 after the burns and then declined gradually, there was no significant difference between survival group and the death group since 21 days after the burns. CONCLUSION These data suggest that severe burns might stimulate the excessive release of HMGB1. As an important late mediator of inflammation,HMGB1 and TNF-α may induce each other and involve in the development of systemic inflammatory response syndrome （SIRS） following severe burns. Dynamic measurement of plasma HMGB1 levels

关 键 词：烧伤 高迁移率族蛋白B1 肿瘤坏死因子-α全身炎症反应 

分 类 号：R446[医药卫生—诊断学]