人高迁移率族蛋白B1、晚期糖基化终产物受体和C反应蛋白与脑外伤术后肺部感染严重程度的相关性及对预后的评估价值  

Correlation between human high mobility group protein B1,receptor of advanced glycation endproducts and C-reactive protein and the severity of pulmonary infection after brain trauma surgery and the evaluation to the prognosis

作　　者：郭金英[1] 李惠霖 马良[1] 王晋霞 张开红[1] Guo Jinying;Li Huilin;Ma Liang;Wang Jinxia;Zhang Kaihong(Department of Clinical Laboratory,Affiliated Peace Hospital,Changzhi Medical College,Changzhi 046000,China;Department of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]长治医学院附属和平医院检验科,长治市046000 [2]山西医科大学医学影像学系,太原市030001

出　　处：《中华实验和临床感染病杂志（电子版）》2020年第4期308-314,共7页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨人高迁移率族蛋白B1(HMGB-1)、晚期糖基化终产物受体(RAGE)、C反应蛋白(CRP)与脑外伤术后肺部感染严重程度的相关性及对预后的评估价值。方法前瞻性选取2016年5月至2018年5月于长治医学院附属和平医院接受治疗的182例脑外伤术后肺部感染者,根据肺部感染CURB-65评分系统标准将患者分为轻度组(74例)、中度组(60例)和重度组(48例),并根据术后30 d临床结局分为生存组(151例)和死亡组(31例)。比较不同感染程度患者血清HMGB-1、RAGE、CRP水平并分析与肺部感染严重程度的相关性。通过Logistic回归分析明确影响患者死亡的危险因素,以受试者工作特征曲线(ROC)评价HMGB-1、RAGE和CRP对脑外伤术后肺部感染者死亡的预测价值。结果重度组患者HMGB-1水平为(10.22±2.35)μg/L,分别高于中、轻度组[(3.89±1.01)μg/L和(2.00±0.40)μg/L],差异有统计学意义(t=18.821、29.502,P均<0.001);重度组患者RAGE水平为(9.01±2.05)ng/L,分别高于中、轻度组患者[(5.89±1.20)ng/L和(2.12±0.22)ng/L],差异有统计学意义(t=9.870、28.722,P均<0.001);重度组患者CRP水平为(50.33±10.32)mg/L,分别高于中、轻度组患者[(32.33±8.52)mg/L和(15.20±3.52)mg/L],差异有统计学意义(t=9.930、27.010,P均<0.001)。中度组患者血清HMGB-1、RAGE和CRP水平均高于轻度组(t=14.744、26.504、15.729,P均<0.001);血清HMGB-1、RAGE和CRP水平均与肺部感染CURB-65评分呈正相关(r=0.696、0.763、0.851,P均<0.001)。182例患者的病死率为17.03%(31/182)。死亡组患者呼吸机应用、气管切开、低蛋白血症占比均显著高于生存组,年龄、HMGB-1、RAGE、CRP、降钙素原(PCT)水平均高于生存组(P均<0.05)。Logistic回归分析年龄、呼吸机应用、气管切开、低蛋白血症、HMGB-1、RAGE、CRP和PCT均为导致患者死亡的危险因素(OR=2.016、2.423、2.252、1.853、2.606、2.199、1.919、1.904,P均<0.05)。ROC曲线分析显示血清HMGB-1、RAGE和CRP预测�Objective To investigate the correlation between human high mobility group protein B1(HMGB-1),receptor of advanced glycation endproducts(RAGE),C-reactive protein(CRP)and the severity of pulmonary infection after brain trauma surgery and to evaluate the prognosis of the disease.Methods Total of 182 patients with pulmonary infection after operation of brain trauma who were treated in Affiliated Peace Hospital,Changzhi Medical College from May 2016 to May 2018,prospectively.According to the CURB-65 scoring system for lung infection(CURB-65),patients were divided into mild group(74 cases),moderate group(60 cases)and severe group(48 cases).According to the clinical outcome of 30 days after operation,the patients were divided into survival group(151 cases)and death group(31 cases).The serum levels of HMGB-1,RAGE and CRP in patients with different infection degrees were compared and their correlation between the severity of pulmonary infection were analyzed,respectively.The risk factors of death were determined by Logistic regression analysis and the predictive value of HMGB-1,RAGE and CRP to the death of patients with pulmonary infection after traumatic brain injury were evaluated by receiver operating characteristic curve(ROC).Results The level of HMGB-1 of patients in severe group was(10.22±2.35)μg/L,significantly higher than those of moderate group[(3.89±1.01)μg/L]and mild group[(2.00±0.40)μg/L],with significant differences(t=18.821,29.502;both P<0.001).The level of RAGE of patients in severe group was(9.01±2.05)ng/L,significantly higher than those of in moderate group[(5.89±1.20)ng/L]and mild group[(2.12±0.22)ng/L],with significant differences(t=9.870,28.722;both P<0.001).The level of CRP of patients in severe group was(50.33±10.32)mg/L,significantly higher than those of the moderate group[(32.33±8.52)mg/L]and mild group[(15.20±3.52)mg/L],with significant differences(t=9.930,27.010;both P<0.001).The serum levels of HMGB-1,RAGE and CRP of patients in moderate group were all higher than those of mild grou

关 键 词：脑外伤 肺部感染 人高迁移率族蛋白B1 晚期糖基化终产物受体 C反应蛋白 

分 类 号：R651.15[医药卫生—外科学]