血清HMGB-1、Mb、CK、IL-6水平预测急性腹部多发伤病情严重程度的意义  

Predictive value of serum HMGB-1,Mb,CK,IL-6 indicators in patients with acute abdominal multiple trauma on severity and prognosis

作　　者：宋超[1] 蔡华忠[1] 周峰[1] 梁亚鹏[1] SONG Chao;CAI Hua-zhong;ZHOU Feng;LIANG Yia-peng(Department of Emergency,Affiliated Hospital of Jiangsu University,Zhenjiang 212000,China)

机构地区：[1]江苏大学附属医院急诊科,江苏镇江212000

出　　处：《中国现代普通外科进展》2020年第1期27-30,共4页Chinese Journal of Current Advances in General Surgery

基　　金：2017年镇江市年度科技创新资金重点研发计划(SH2017025)。

摘　　要：目的:探讨急性腹部多发伤患者血清迁移率蛋白-1(HMGB-1)、肌红蛋白(Mb)、肌酸激酶(CK)、白细胞介素-6(IL-6)表达水平预测病情严重程度的价值。方法:2014年1月—2017年1月收治腹部多发伤患者100例,测定血清HMGB-1、Mb、CK及IL-6水平,根据是否发生多器官功能障碍综合征(MODS)分为MODS组和非MODS组,记录患者生存预后结果。结果:MODS组血清HMGB-1、Mb、CK、IL-6水平均明显高于非MODS组(P<0.05)。HMGB-1、Mb、CK、IL-6四种指标联合预测MODS ROC曲线下面积为0.853,预测诊断特异度为78.00%,敏感度为92.60%,血清指标单独预测及联合预测MODS均具有一定价值。入组患者总死亡率为17.65%,HMGB-1预测生存结局曲线下面积最大,为0.805,诊断预测的特异度为83.30%,敏感度为80.60%。联合指标预测生存结局价值较低,而四种单独预测生存结局有一定价值。结论:HMGB-1、Mb、CK、IL-6表达水平与MODS发生具有相关性,4种指标单独或联合预测病情均具有一定价值,单独预测生存预后结局有一定价值,4种指标联合预测生存预后结局价值较低。Objective:To investigate the expression level of HMGB-1,Mb,CK,IL-6 and Predictive value of HMGB-1,Mb,CK,IL-6 in patients with acute abdominal multiple trauma on severity and prognosis.Methods:A prospective cohort study was conducted to enroll 100 patients with multiple traumatic injuries in the emergency department of our hospital.The time of enrollment was from January 2014 to January 2017.When the condition was stable on the day of the visit,blood samples were taken to determine serum HMGB-1,Mb,CK and IL-6.According to whether occurring MODS during hospitalization,the patients was divided into MODS group and non-MODS group.Then the severity of illness was determined by MODS.And the survival of all patients was followed.Results:The serum HMGB-1,Mb,CK,and IL-6 levels of patients in MODS group were higher than those in non-MODS group,and the differences were statistically significant(P<0.05).The Area under the ROC curve of combined indicators of HMGB-1,Mb,CK and IL-6 for predicting MODS was 0.853.The predicted diagnostic specificity was 78.00%,and the sensitivity was 92.60%.Separate prediction of serum indicators and combined prediction for MODS had a certain value.The total mortality rate of the patients enrolled was 17.65%.The area under the ROC curve of HMGB-1for survival outcome MODS was 0.805,the specificity of the diagnostic prediction was 83.30%,and the sensitivity was 80.60%.The separate indicator predicted survival outcome had a certain value.But the combined indicators predicted survival outcome had a lower value.Conclusion:The expression levels of HMGB-1,Mb,CK and IL-6 are correlated with the occurrence of MODS.The four indicators alone or in combination have certain value in predicting disease situation.The four single indicators have certain value in predicting survival outcome,but the survival outcome for predicting value is lower.

关 键 词：腹部多发伤 多器官功能障碍综合征 血清迁移率蛋白-1 肌红蛋白 肌酸激酶 白细胞介素-6 

分 类 号：R656.1[医药卫生—急诊医学]