急性胆管炎患者血清高迁移率族蛋白B1的临床意义研究  

Clinical significance of serum high mobility group box-1 protein in patients with acute cholangitis

作　　者：沈晓东[1] 吴旭波[1] 胡志秋[1] 常奇蒙[1] 杨彪[1] 张紫平[1] Shen Xiaodong;Wu Xubo;Hu Zhiqiu;Chang Qimeng;Yang Biao;Zhang Ziping(Department of General Surgery,Minhang Hosphal,Fudan University,Shanghai 201199,China)

机构地区：[1]复旦大学附属闵行医院普外科,上海201199

出　　处：《中华普通外科杂志》2019年第10期883-886,共4页Chinese Journal of General Surgery

摘　　要：目的分析急性胆管炎患者手术前后血清高迁移率族蛋白B1(HMGB1)的表达,在急性胆管炎严重程度分级中的意义.方法回顾性分析2017年1-12月胆总管结石伴急性胆管炎病例118例,检测内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)手术前后血清HMGB1水平,分析其与病情轻重的关系以及HMGB1与其他生化指标的相关性.结果健康体检组、轻度胆管炎组、中度胆管炎组、重度胆管炎组血清HMGB1水平分别为(1.74±0.79)μg/L、(9.19 ±4.86)μg/L、(12.62 ±4.13)μg/L、(18.02 ±3.84)μg/L,差异有统计学意义(F=63.348,P<0.05),三组经ERCP治疗后其血清水平较术前明显下降,差异有统计学意义(t=10.978,t=35.682,t =42.649;P<0.05),血清HMGB1水平与白细胞计数、CRP、总胆红素、直接胆红素、丙氨酸氨基转移酶呈正相关性.结论血清HMGB1水平在急性胆管炎患者血清中显著升高,且病情越重,升高越明显,经ERCP治疗后,其水平较前明显下降.HMGB1是评价急性胆管炎严重程度的有效参数.Objective To analyze perioperative serum high mobility group box-1 protein (HMGB1) levels in patients with acute cholangitis and its clinical significance.Methods 118 cases of choledocholithiasis with acute cholangitis were retrospectively analyzed,admittd in Minhang Hospital from Jan 2017 to Dec 2017.Enzyme linked immunosorbent assay (ELISA) was used to detect serum HMGB1 levels before and after ERCP.The relationship between serum HMGB1 levels and severity of the disease was analyzed.Results The serum HMGB1 levels in the healthy controls,mild cholangitis group,moderate cholangitis group and severe cholangitis group were(1.74 ±0.79)μg/L,(9.19 ±4.86)μg/L,(12.62 ± 4.13)μg/L,(18.02 ±3.84)μg/L,respectively.The serum HMGB1 levels were significantly different in these four groups (F =63.348,P < 0.05).The serum HMGB1 levels in the three groups after ERCP were significantly lower than those before ERCP (t =10.978,t =35.682,t =42.649;P < 0.05).The serum HMGB1 levels were positively correlated with WBC,CRP,total bilirubin,direct bilirubin and alanine aminotransferase.Conclusion Serum HMGB1 levels were significantly higher in patients with acute cholangitis,and the more serious the disease,the higher the HMGB1 levels.After ERCP,serum HMGB1 levels were significantly lower than before.HMGB1 is an effective parameter for evaluating the severity of acute cholangitis.

关 键 词：胆管炎 高迁移率族蛋白质类 胰胆管造影术 内窥镜逆行 

分 类 号：R575[医药卫生—消化系统] R657[医药卫生—内科学]