急性颅脑损伤患儿血清HMGB1的变化及其临床意义  

The changes and clinical significance of serum high mobility group box-1 protein level of children's patients with acute traumatic brain injury

作　　者：王林霞[1] 汤鲁明[1] 王敏[1] 严纯雪[1] 潘国权[1] 

机构地区：[1]温州医科大学附属第二医院儿童ICU,浙江温州325027

出　　处：《中国现代医生》2015年第22期5-8,共4页China Modern Doctor

基　　金：浙江省温州市科技计划项目(Y20120108);浙江省医药卫生科技计划项目(2013RCA039)

摘　　要：目的探讨TBI患儿早期外周血HMGB1表达变化及其临床意义。方法将87例急性TBI患儿根据格拉斯哥评分分成三组：严重组（≤8分）、中度组（9~12分）、轻度组（13~15分）,分别在伤后3 h、6 h、12 h、24 h、48 h采集静脉血,采用酶联免疫吸附试验（ELISA）检测血清HMGB1含量;同时根据严重组患儿28 d内是否死亡、是否发生脓毒症或急性肺损伤分组,比较组间HMGB1的表达。结果重度组在各时间点HMGB1水平均显著高于轻、中度组（P〈0.01）;中度损伤组较轻度损伤组在6 h、12 h、24 h、48 h明显升高（P〈0.01）;死亡组患者血清HMGB1水平较存活组显著升高（P〈0.01）;发生脓毒症及急性肺损伤病例血清HMGB1显著均高于未发生脓毒症及急性肺损伤病例（P〈0.01）。结论颅脑损伤患儿早期血清HMGB1即升高,且可能作为一种＂预警信号＂预测损伤严重度及预后、并发症的发生。Objective To investigate the serum high mobility group box-1 protein level of children＇s patients with a- cute traumatic brain injury and it＇s expression changes and clinical significance. Methods A total of 87 children＇s patients with acute traumatic brain injury were randomly divided into three groups： severe group （≤8 scores）, moderate group（9 to 12 scores） and minor group（13 to 15 scores） according to the patients＇ Glasgow Coma Scale on admission. Their venous blood were drawn at 3 h, 6 h, 12 h, 24 h, 48 h after injury and the serum HMGB1 were determined by en zyme linked immunosorbent assay（ELISA）. The serum HMGB1 concentration were compared between different groups, survivors and non-survivors in 28 days, patients who developed acute lung injury（ALI） or sepsis and who did not deve- lope ALI or sepsis in severe injury group. Results Compared with the minor and moderate group, the serum HMGB1 level in severe group were significantly elevated at each time points（P〈0.01）. At 6 h, 12 h, 24 h, 48 h time points, the serum HMGB1 level in the moderate group increased significantly compared with the minor group （P〈0.01）. The serum HMGB1 levels at 24 h after injury were higher in non-survivors compared with survivors （P〈0.01）. The serum HMGB1 levels in those patients who developed acute lung injury （ALI） or sepsis were higher than who did not develope ALI or sepsis （P〈O.O1）. Conclusion The serum HMGB1 concentration is increased early and may be a ＇alarm signal＇ prog- nosticating prognosis and complication after acute traumatic brain injury in children.

关 键 词：急性颅脑损伤 高迁移率族蛋白B1 儿童患者 脓毒症 急性肺损伤 

分 类 号：R651.15[医药卫生—外科学]