脑外伤继发颅内感染患者血浆细胞因子及高迁移率族蛋白-1表达与病情相关性  

Correlation between plasma cytokines,high-mobility group box 1protein and illness condition of brain trauma patients with secondary intracranial infection

作　　者：庞文勇 戴柯 韩全胜[1] 傅俊武 陈勇[1] 李鑫[1] 王俊[1] PANG Wen-yong;DAI Ke;HAN Quan-sheng;FU Jun-wu;CHEN Yong;LI Xin;WANG Jun(Guizhou Provincial People's Hospital,Guiyang,Guizhou 550002,China)

机构地区：[1]贵州省人民医院急诊外科,贵州贵阳550002

出　　处：《中华医院感染学杂志》2020年第5期713-716,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科研基金资助项目(7927023)。

摘　　要：目的探究脑外伤继发颅内感染患者血浆细胞因子及高迁移率族蛋白-1(HMGB-1)、晚期糖基化终产物受体(RAGE)表达与病情相关性.方法选择2015年1月-2018年12月贵州省人民医院急诊外科收治的脑外伤继发颅内感染患者60例作为研究对象,根据感染程度分为:轻度感染29例、中度感染20例、重度感染11例;同期收治的脑外伤未感染患者30例作为未感染组.比较不同感染程度和未感染组RAGE、HMGB-1、辅助型T细胞(Th)1、Th2、Th1/Th2细胞比率、血浆细胞因子水平及血液流变学指标.结果随着感染程度加重,HMGB-1及RAGE水平不断增加,均高于未感染组(均P<0.001);Th1、Th1/Th2比例不断降低,Th2比例不断升高,与未感染组比较,差异具有统计学意义(均P<0.001);随着感染程度加重,IL-4、IL-6水平逐渐升高,均高于未感染组,差异具有统计学意义(均P<0.001),血浆黏度、全血黏度低切、全血黏度高切、Fib血液流变学指标逐渐升高,与未感染组比较,差异均具有统计学意义(均P<0.001).结论脑外伤继发颅内感染患者体内细胞因子含量异常,Th1/Th2平衡偏移,血液流变学异常,HMGB-1及其主要受体RAGE表达显著上升,与病情严重程度密切相关.OBJECTIVE To explore the correlation between the plasma cytokines, advanced glycation end product Receptor for(RAGE), high-mobility group box 1 protein(HMGB-1) and illness condition of the trauma patients with secondary intracranial infection. METHODS A total of 60 brain trauma patients with secondary intracranial infection who were treated in emergency surgery department of Guizhou Provincial People’s Hospital from Jan 2015 to Dec 2018 were recruited as the study objects, of whom 29 had mild infection, 20 had moderate infection, and 11 had severe infection. Meanwhile, 30 brain trauma patients who did not have infection were set as the non-infection group. The levels of HMGM-1, RAGE, helper T cell(Th)1, Th2, ratio of Th1 to Th2, plasma cytokines and hemorheology indexes were observed and compared among the infection groups and the non-infection group. RESULTS With the aggravation of severity of infection, the levels of HMGB-1 and Receptor for were constantly elevated, and the levels of above indexes of the infection groups were significantly higher than those of the non-infection group(all P<0.001);the Th1 and ratio of Th1 to Th2 constantly declined, the percentage of Th2 was constantly elevated, as comparted with those of the non-infection group(all P<0.001). With the aggravation of severity of infection, the levels of IL-4 and IL-6 were constantly elevated, the levels of IL-4 and IL-6 of the infection groups were significantly higher than those of the non-infection group(all P<0.001). The plasma viscosity, low shear viscosity, high shear viscosity and Fib hemorheology indexes of the infection groups were significantly elevated, as compared with the non-infection group( all P<0.001). CONCLUSION The brain trauma patients with secondary intracranial infection have the abnormal levels of plasma cytokines, shift of Th1/Th2 balance, abnormal hemorheology indexes and remarkable rise of HMGB-1 as well as the major receptor RAGE, which are closely associated with the illness condition.

关 键 词：细胞因子 高迁移率族蛋白-1 晚期糖基化终产物受体 脑外伤 颅内感染 TH1/TH2 血液流变学 

分 类 号：R651.1[医药卫生—外科学]