中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
12期
1123-1126
,共4页
欧阳军%武礼琴%彭心宇%帕哈提
歐暘軍%武禮琴%彭心宇%帕哈提
구양군%무례금%팽심우%파합제
呼吸窘迫综合征,成人%多器官功能障碍综合征%高迁徙率族蛋白质类
呼吸窘迫綜閤徵,成人%多器官功能障礙綜閤徵%高遷徙率族蛋白質類
호흡군박종합정,성인%다기관공능장애종합정%고천사솔족단백질류
Respiratory distress syndrome,adult%Multiple organ failure%High mobility group proteins
目的 研究创伤性急性肺损伤(acute lung injury,ALI)后血清高迁移率蛋白-1(high mobility group box 1 protein,HMGB -1)的水平变化,探讨其与MODS、急性生理学与慢性健康状况Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)评分的相关性,以及其对MODS发生率和死亡率的预警作用. 方法 测定10例正常人与40例ALI患者伤后第1,4,7天的血清HMGB -1水平.根据MODS的诊断标准,将损伤组分为两组:MODS组13例,非MODS组27例.同时评定其MODS、APACHEⅡ分值. 结果 组间比较:非MODS组第1,4,7天HMGB -1水平的表达均高于MODS组(P＜0.05)；非MODS组HMGB -1水平的表达高于正常对照组,但低于MODS组.组内比较:非MODS组第4天HMGB -1水平的表达明显高于第1天(P＜0.01),第7天较第4天明显降低(P＜0.01),甚至低于第1天.MODS组血清HMGB -1水平的表达显著升高,并延续数天,第7天较第4天有所降低,但仍高于第1天.伤后第1,4,7天MODS评分随HMGB -1水平的动态变化差异明显.伤后第1,4,7天APACHEⅡ评分比较,差异明显.相关性分析显示,HMGB -1水平的表达与MODS评分、APACHEⅡ评分显著相关. 结论 (1)HMGB -1在ALI患者中呈高表达,其作为晚期炎症介质参与炎性反应往往升高较晚,且持续时间较长.(2)HMGB -1水平变化与并发MODS密切相关.(3)常规检测血清HMGB -1水平并联合评定MODS、APACHEⅡ评分有助于对创伤后脏器功能不全的预测.
目的 研究創傷性急性肺損傷(acute lung injury,ALI)後血清高遷移率蛋白-1(high mobility group box 1 protein,HMGB -1)的水平變化,探討其與MODS、急性生理學與慢性健康狀況Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)評分的相關性,以及其對MODS髮生率和死亡率的預警作用. 方法 測定10例正常人與40例ALI患者傷後第1,4,7天的血清HMGB -1水平.根據MODS的診斷標準,將損傷組分為兩組:MODS組13例,非MODS組27例.同時評定其MODS、APACHEⅡ分值. 結果 組間比較:非MODS組第1,4,7天HMGB -1水平的錶達均高于MODS組(P＜0.05)；非MODS組HMGB -1水平的錶達高于正常對照組,但低于MODS組.組內比較:非MODS組第4天HMGB -1水平的錶達明顯高于第1天(P＜0.01),第7天較第4天明顯降低(P＜0.01),甚至低于第1天.MODS組血清HMGB -1水平的錶達顯著升高,併延續數天,第7天較第4天有所降低,但仍高于第1天.傷後第1,4,7天MODS評分隨HMGB -1水平的動態變化差異明顯.傷後第1,4,7天APACHEⅡ評分比較,差異明顯.相關性分析顯示,HMGB -1水平的錶達與MODS評分、APACHEⅡ評分顯著相關. 結論 (1)HMGB -1在ALI患者中呈高錶達,其作為晚期炎癥介質參與炎性反應往往升高較晚,且持續時間較長.(2)HMGB -1水平變化與併髮MODS密切相關.(3)常規檢測血清HMGB -1水平併聯閤評定MODS、APACHEⅡ評分有助于對創傷後髒器功能不全的預測.
목적 연구창상성급성폐손상(acute lung injury,ALI)후혈청고천이솔단백-1(high mobility group box 1 protein,HMGB -1)적수평변화,탐토기여MODS、급성생이학여만성건강상황Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)평분적상관성,이급기대MODS발생솔화사망솔적예경작용. 방법 측정10례정상인여40례ALI환자상후제1,4,7천적혈청HMGB -1수평.근거MODS적진단표준,장손상조분위량조:MODS조13례,비MODS조27례.동시평정기MODS、APACHEⅡ분치. 결과 조간비교:비MODS조제1,4,7천HMGB -1수평적표체균고우MODS조(P＜0.05)；비MODS조HMGB -1수평적표체고우정상대조조,단저우MODS조.조내비교:비MODS조제4천HMGB -1수평적표체명현고우제1천(P＜0.01),제7천교제4천명현강저(P＜0.01),심지저우제1천.MODS조혈청HMGB -1수평적표체현저승고,병연속수천,제7천교제4천유소강저,단잉고우제1천.상후제1,4,7천MODS평분수HMGB -1수평적동태변화차이명현.상후제1,4,7천APACHEⅡ평분비교,차이명현.상관성분석현시,HMGB -1수평적표체여MODS평분、APACHEⅡ평분현저상관. 결론 (1)HMGB -1재ALI환자중정고표체,기작위만기염증개질삼여염성반응왕왕승고교만,차지속시간교장.(2)HMGB -1수평변화여병발MODS밀절상관.(3)상규검측혈청HMGB -1수평병연합평정MODS、APACHEⅡ평분유조우대창상후장기공능불전적예측.
Objective To study the changes of serum high mobility group box 1 protein ( HMGB-1 ) in patients with traumatic acute lung injury (ALI) and determine its correlations with MODS,acute physiology and chronic health evaluation ( APACHE Ⅱ ) scores and whether it can predict the incidence of MODS and mortality.Methods Forty cases of ALI were divided into MODS group (n =13) and nonMODS group (n =27) according to the MODS evaluation standard.The serum HMGB-1 was determined in the control group ( 10 healthy persons) and the MODS and non-MODS groups at days 1,4 and 7.The MODS and APACHE Ⅱ scores were also evaluated.Results Between the groups,the HMGB-1 level at days 1,4 and 7 in non-MODS group was higher than that in the control group,while lower than that in MODS group (P＜0.05).Within the non-MODS group,the expression of HMGB-1 showed a high level at day 4 compared with that at day 1 ( P ＜0.01 ) ; the HMGB-1 showed a low level at day 7 with clinical symptom improvement compared with that at day 4,and was even lower than that at day 1 ( P ＜ 0.01 ).Within the MODS group,the serum HMGB-1 level was significantly increased,and continued for several days; the HMGB-1 was decreased slightly at day 7 in comparison with that at day 4,but was still higher than that at day 1.The difference of MODS and APACHE Ⅱ score was significant,with the dynamic change of HMGB-1 level at days 1,4 and 7 after traumatic ALI.The correlative analysis showed that HMGB-1 expression level was remarkably related with MODS score and APACHE Ⅱ score.Conclusions HMGB-1 shows a high expression in patients with traumatic ALI.As a late mediator of inflammation,HMGB-1 usually increases relatively late and lasts for a long duration.HMGB-I level and concurrency MODS are closely related.Routine test of serum HMGB-1 level and joint assessment of MODS and APACHE Ⅱ score are contributive to the prediction of organ dysfunction after traumatic ALI.
