重症肺炎患者血清高迁移率族蛋白B1、血小板与淋巴细胞比值、营养状态与预后的关系  

The relationship between the serum high mobility group protein B1,platelet to lymphocyte ratio,nutritional status and the prognosis in patients with severe pneumonia

作　　者：计文韬[1] 虞有超 丁玲[1] 潘文静 王玉楼 姚屹瑾[1] JI Wen-tao;YU You-chao;DING Ling;PAN Wen-jing;WANG Yu-lou;YAO Yi-jin(Ruijin Hospital Affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院,上海200025

出　　处：《实用医院临床杂志》2024年第5期56-60,共5页Practical Journal of Clinical Medicine

基　　金：国家自然科学基金资助项目(编号:82200023)。

摘　　要：目的探讨重症肺炎患者血清高迁移率族蛋白B1(HMGB1)、血小板与淋巴细胞比值(PLR)、营养状态与预后的关系。方法选取2021年3月至2023年3我院收治的肺炎患者156例,按照临床肺部感染评分(CPIS)分为重症肺炎组75例和普通肺炎组81例,选择同期我院健康体检人群80例作为对照组;根据重症肺炎患者随访30 d的疾病转归情况分为预后良好组52例与预后不良组23例。比较各组血清HMGB1、PLR、营养状态[总蛋白(TP)、转铁蛋白(TRF)、血红蛋白(Hb)水平]。分析重症肺炎患者血清HMGB1、PLR、营养状态与患者急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)和CPIS的关系,分析影响重症肺炎患者预后的因素。结果重症肺炎组、普通肺炎组血清HMGB1、PLR高于对照组,TP、TRF、Hb水平低于对照组(P<0.05);且重症肺炎组血清HMGB1、PLR高于普通肺炎组,TP、TRF、Hb水平低于普通肺炎组(P<0.05)。重症肺炎组血清HMGB1、PLR与APACHEⅡ评分、CPIS评分呈正相关,TP、TRF、Hb水平与APACHEⅡ评分、CPIS评分呈负相关(P<0.05)。预后良好组血清HMGB1、PLR低于预后不良组,TP、TRF、Hb水平高于预后不良组(P<0.05)。血清高HMGB1、PLR和低TP、TRF、Hb水平均为影响重症肺炎患者预后的危险因素(P<0.05)。结论重症肺炎患者血清HMGB1、PLR呈升高趋势,营养指标TP、TRF、Hb水平呈下降趋势,且与患者病情及预后具有明显相关性,血清HMGB1、PLR越高,营养指标TP、TRF、Hb水平越低,患者预后会更差。Objective To investigate the relationship between the serum high mobility group protein B1(HMGB1),platelet-to-lymphocyte ratio(PLR)and nutritional status and the prognosis in patients with severe pneumonia.Methods One hundred and fifty-six patients with pneumonia admitted to our hospital from March 2021 to March 2023 were selected.The patients were divided into a severe pneumonia group(n=75)and a common pneumonia group(n=81)according to clinical pulmonary infection score(CPIS).In addition,80 healthy people with physical examination in our hospital during the same period were taken as a control group.Patients with severe pneumonia were further classified into a good prognosis group(n=52)and a poor prognosis group(n=23)according to the disease outcomes after 30 days of follow-up.Serum HMGB1,PLR,nutritional status assessed by total protein(TP),transferrin(TRF)and hemoglobin(Hb)were compared among the groups.The relationship between serum HMGB1,PLR,nutritional status and Acute Physiology and Chronic EvaluationⅡ(APACHEⅡ)and CPIS in patients with severe pneumonia was analyzed.The factors affecting the prognosis in patients with severe pneumonia were also analyzed.Results Serum levels of HMGB1 and PLR in the severe pneumonia group and the common pneumonia group were higher than those in the control group while the levels of TP,TRF and Hb were lower than those in the control group(P<0.05).The levels of serum HMGB1 and PLR in severe pneumonia group were higher than those in the common pneumonia group while the levels of TP,TRF and Hb were lower than those in the common pneumonia group(P<0.05).Serum HMGB1 and PLR in the severe pneumonia group were positively correlated with the APACHEⅡscore and the CPIS score while serum TP,TRF and Hb levels were negatively correlated with the APACHEⅡscore and the CPIS score(P<0.05).The levels of serum HMGB1 and PLR in the good prognosis group were lower while the levels of TP,TRF and Hb were higher compared with those in the poor prognosis group(P<0.05).High levels of serum HMGB1

关 键 词：重症肺炎 血清高迁移率族蛋白B1 血小板与淋巴细胞比值 营养状态 预后 

分 类 号：R563.1[医药卫生—呼吸系统]