HMGB1早期预测重症急性胰腺炎患者发生PICS的价值研究  

Value of HMGB1 in early prediction of PICS in severe acute pancreatitis patients

作　　者：李彩霞 孟文勤 郝颖楠 张勇刚[2] LI Caixia;MENG Wenqin;HAO Yingnan;ZHANG Yonggang(Department of Critical Care Medicine,People's Hospital of Inner Mongolia Autonomous Region,Hohhot,010020,China;Department of Abdominal Surgery,Inner Mongolia Autonomous Region Cancer Hospital,People's Hospital Affiliated to Inner Mongolia Medical University)

机构地区：[1]内蒙古自治区人民医院重症医学科,呼和浩特010020 [2]内蒙古自治区肿瘤医院(内蒙古医科大学附属人民医院)腹部外科

出　　处：《临床急诊杂志》2022年第12期859-862,869,共5页Journal of Clinical Emergency

基　　金：内蒙古自治区自然科学基金(No:N2015-1342)。

摘　　要：目的:探讨血清高迁移率族蛋白B1(HMGB1)预测重症急性胰腺炎(SAP)患者发生持续炎症反应-免疫抑制-分解代谢综合征(PICS)的价值。方法:选取2018年1月—2020年12月内蒙古自治区人民医院收治的SAP患者141例,根据是否发生PICS将患者分为PICS组(n=39)和无PICS组(n=102)。酶联免疫吸附试验检测入院24 h、48 h、7 d、14 d时血清HMGB1表达水平。PICS影响因素分析采用logistic多因素分析;采用受试者工作特征曲线(ROC)分析HMGB1预测PICS的价值,计算曲线下面积(AUC)、灵敏度和特异度。结果:PICS组患者入院24 h、48 h、7 d、14 d时血清HMGB1表达水平均高于无PICS组(P<0.05)。logistic多因素分析结果显示,APACHEⅡ评分、C-反应蛋白水平、HMGB1入院24 h水平、HMGB1入院48 h水平为SAP患者发生PICS的独立影响因素(P<0.05)。HMGB1入院24 h水平预测SAP患者发生PICS的AUC为0.940,灵敏度为92.05%、特异度为91.47%;HMGB1入院48 h水平预测SAP患者发生PICS的AUC为0.785,灵敏度为80.07%、特异度为84.00%。结论:早期检测血清HMGB1水平有助于预测SAP患者发生PICS。Objective: To investigate the value of serum high mobility group box B1(HMGB1) in predicting persistent inflammatory response-immunosuppression-catabolic syndrome(PICS) in patients with severe acute pancreatitis(SAP). Methods: A total of 141 SAP patients admitted to our hospital from January 2018 to December 2020 were selected, and the patients were divided into PICS group(n=39) and none-PICS group(n=102) according to whether PICS occurred. The expression level of serum HMGB1 was detected by ELISA at 24 h, 48 h, 7 d and 14 d after admission. Logistic multivariate analysis was used to analyze the influencing factors of PICS;receiver operating characteristic curve(ROC) was used to analyze the value of HMGB1 in predicting PICS, and the area under the curve(AUC), sensitivity and specificity were calculated. Results: The expression levels of serum HMGB1 in the PICS group were higher than those in the non-PICS group at 24 h, 48 h, 7 d, and 14 d after admission(P<0.05). Logistic multivariate analysis showed that APACHE Ⅱ score, CRP level, HMGB1 level at 24 hours after admission, and HMGB1 level at 48 hours after admission were the independent influencing factors of PICS in SAP patients(P<0.05). The AUC of HMGB1 level at 24 hours after admission was 0.940, the sensitivity was 92.05%, and the specificity was 91.47%;the AUC of HMGB1 level at 48 hours after admission was 0.785, the sensitivity was 80.07%, and the specificity was 84.00%. Conclusion: Early detection of serum HMGB1 level is helpful to predict PICS in SAP patients.

关 键 词：血清 高迁移率族蛋白B1 重症急性胰腺炎 持续炎症反应-免疫抑制-分解代谢综合征 预测 

分 类 号：R656.1[医药卫生—急诊医学]