重型颅脑损伤患者血清高迁移率族蛋白B1、白细胞介素-1和白细胞介素-6、S100B蛋白的水平变化及临床意义  

Changes and clinical significance of serum high mobility group box B1,interleukin-1 and interleukin-6 and S100B levels in patients with severe traumatic brain injury

作　　者：丁燕晶[1] 叶嘉辉 莫海军[1] 李金庭[1] 林燕金[1] 陈甘海[1] DING Yan-jing;YE Jia-hui;MO Hai-jun;LI Jin-ting;LIN Yan-jin;CHEN Gan-hai

机构地区：[1]广东省东莞市厚街医院ICU,广东东莞523945

出　　处：《中国药物经济学》2018年第5期34-37,共4页China Journal of Pharmaceutical Economics

基　　金：广东省东莞市医疗卫生类科研项目(No.201610515001203)

摘　　要：目的通过探讨重型颅脑损伤(TBI)患者血清高迁移率族蛋白B1、白细胞介素-1和白细胞介素-6、S100B蛋白的水平变化,分析其临床意义,并判断其与患者预后的相关性。方法收集2016年7月至2017年5月于广东省东莞市厚街医院重症监护病房(ICU)收治的成年重型颅脑损伤患者资料100例作为观察组,其中男52例,女48例。同时收集该院同期健康体检者100例作为对照组,其中男、女各50例。对入选对象的血清高迁移率族蛋白B1(HMGB1)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、S100B蛋白等水平进行测定,所有患者住院期间每日进行GCS评分,同时动态观察瞳孔、CT等情况。结果对照组体检者HMGB1为(1.59±0.98)μg/ml,S100B蛋白为(2.11±0.18)ng/ml,IL-1为(0.51±0.48)ng/ml,IL-6为(0.19±0.19)ng/ml;与观察组患者第1天各项指标含量比较,各时点均有显著下降,差异均有统计学意义(均P<0.05);观察组各时点HMGB1、IL-1、IL-6、S100B蛋白水平与对照组比较,差异均有统计学意义(均P<0.05);与术后第1天比较,观察组各时点GCS评分均显著升高,差异有统计学意义(P<0.05);重型颅脑损伤患者各项血清学指标与GCS评分呈显著负相关,与颅脑损伤严重程度呈正相关。结论 HMGB1、IL-1、IL-6、S100B蛋白的检测能够有效反映重型颅脑损伤患者的颅脑损伤程度,可有效协助临床医师进行患者颅脑情况的判定,将有可能提高重型颅脑损伤患者的抢救成功率,减少死亡率,改善预后。Objective Through the discussion of severe traumatic brain injury（TBI） changes of serum levels ofhigh mobility group protein B1,interleukin-1 and interleukin-6,S100 B,to analyze its clinical significance,and to determine its relationship with the prognosis of the patients.Methods A total of 100 patients with severe craniocerebral injuries admitted in our hospital from July 2016 to May ICU,including 52 males and 48 females,were collected from.At the same time,100 cases of physical examination in the same period were collected,including 50 cases of male and female.The serum HMGB1,IL-1,IL-6,S100 B protein levels were measured in all the patients.GCS scores were performed daily during hospitalization,and the pupils, CT,and so on were dynamically observed.Results The content of HMGB1 in the control group was（1.59＋0.98） μg/ml,the content of S100 B was（2.11＋0.18） ng/ml,the content of IL-1 was（0.51＋0.48） ng/ml,and the content of IL-6 was（0.19＋0.19） ng/ml.Comparison of first days the content of each index,each time point were significantly decreased,the difference was statistically significant（P〈0.05）;compared with normal control,the differences were statistically significant（P〈0.05）;each time point were significantly increased,the difference was statistically significant（P〈0.05）,heavy craniocerebral injury patients with various serological the index and GCS score was negatively correlated,positively correlated with the severity of TBI.Conclusion The detection of HMGB1,IL-1,IL-6,S100 B index can reflect the degree of brain injury patients with severe craniocerebral injury,and to determine the effective assist clinicians in patients with brain conditions,it will be possible to improve the success rate of rescue of patients with severe craniocerebral injury,reduce mortality,improve the prognosis.

关 键 词：重型颅脑损伤 血清学指标 临床意义 

分 类 号：R651.15[医药卫生—外科学]