CAJ | 학술논문

目的探讨血清高迁移率族蛋白B1(HMGB1)和超敏C-反应蛋白(hs-CRP)水平在急性脑梗死(ACI)发病中的意义.方法选择发病72h内入院的ACI患者40例,分别于入院24 h内及病程7d、12d抽取静脉血,用酶联免疫吸附试验检测血清HMGB1、hs-CRP水平.结果 ACI患者入院后各时间点血清HMGB1水平(μg/L,24 h:7.598±0.280,7d:10.491±0.512,12 d:5.315±0.224)均显著高于健康对照组(20例,2.994±0.243)及存在高血压、糖尿病、高脂血症等至少1项的危险因素组(20例,3.272±0.285),差异均有统计学意义(均P＜0.01)；血清hs-CRP水平(mg/L,24 h:5.815±0.408,7d:5.063±0.510,12d:2.863±0.297)也均明显高于健康对照组(0.642±0.047),差异均有统计学意义(均P＜0.01),12d时hs-CRP水平接近危险因素组(2.514±0.312),差异无统计学意义(P＞0.05).危险因素组患者血清HMGB1水平高于健康对照组,但差异无统计学意义(P＞0.05);而血清hs-CRP水平明显高于健康对照组(P＜0.01).椎-基底动脉系统梗死者(17例)与颈内动脉系统梗死者(23例)血清HMGB1、hs-CRP水平相当,说明血清HMGB1、hs-CRP水平与梗死部位无相关关系,而二者与美国国立卫生院卒中量表(NIHSS)评分呈正相关关系(r1=0.377、P1=0.034,r2=0.353、P2=0.025).此外,血清HMGB1水平与hs-CRP水平呈显著正相关关系(r=0.428,P=0.047).结论血清炎症因子HMGB1、hs-CRP在ACI的发病中起重要作用,其水平与病情轻重相关,与脑梗死部位无关.血清hs-CRP水平可能对ACI的发生有预测意义,监测血清HMGB1、hs-CRP水平有助于ACI病情判断及预后评价.
목적 탐토혈청고천이솔족단백B1(HMGB1)화초민C-반응단백(hs-CRP)수평재급성뇌경사(ACI)발병중적의의.방법 선택발병72h내입원적ACI환자40례,분별우입원24 h내급병정7d、12d추취정맥혈,용매련면역흡부시험검측혈청HMGB1、hs-CRP수평.결과 ACI환자입원후각시간점혈청HMGB1수평(μg/L,24 h:7.598±0.280,7d:10.491±0.512,12 d:5.315±0.224)균현저고우건강대조조(20례,2.994±0.243)급존재고혈압、당뇨병、고지혈증등지소1항적위험인소조(20례,3.272±0.285),차이균유통계학의의(균P＜0.01)；혈청hs-CRP수평(mg/L,24 h:5.815±0.408,7d:5.063±0.510,12d:2.863±0.297)야균명현고우건강대조조(0.642±0.047),차이균유통계학의의(균P＜0.01),12d시hs-CRP수평접근위험인소조(2.514±0.312),차이무통계학의의(P＞0.05).위험인소조환자혈청HMGB1수평고우건강대조조,단차이무통계학의의(P＞0.05);이혈청hs-CRP수평명현고우건강대조조(P＜0.01).추-기저동맥계통경사자(17례)여경내동맥계통경사자(23례)혈청HMGB1、hs-CRP수평상당,설명혈청HMGB1、hs-CRP수평여경사부위무상관관계,이이자여미국국립위생원졸중량표(NIHSS)평분정정상관관계(r1=0.377、P1=0.034,r2=0.353、P2=0.025).차외,혈청HMGB1수평여hs-CRP수평정현저정상관관계(r=0.428,P=0.047).결론 혈청염증인자HMGB1、hs-CRP재ACI적발병중기중요작용,기수평여병정경중상관,여뇌경사부위무관.혈청hs-CRP수평가능대ACI적발생유예측의의,감측혈청HMGB1、hs-CRP수평유조우ACI병정판단급예후평개.
Objective To study the potential role of high mobility group box-1 protein (HMCB1) and high-sensitivityC-reactiveprotein (hs-CRP) in acute cerebral infarction (ACI).Methods Forty patients with ACI were enrolled within 72 hours after onset of symptom in this study.Venous blood samples were collected within 24 hours of admission,7th day and 12th day after admission.Serum HMGB1 and hs-CRP levels were measured with enzyme linked immunosorbent assay (ELISA) method.Results Serum HMGB1 levels (μg/L) at all time points (24 hours:7.598 ± 0.280,7th day:10.491 ± 0.512,12th day:5.315 ± 0.224) were siguificantly higher than those of healthy controls ( n =20,2.994 ± 0.243 ) and risk factor group in which patients suffered from one risk factor in hypertension,diabetes mellitus,and hyperlipemia at least (n=20,3.272 ± 0.285),with significant difference (all P＜0.01 ).Serum hs-CR P levels (mg/L,24 hours:5.815 ± 0.408,7th day:5.063 ± 0.51 0,12th day:2.863 ± 0.297 ) of the patients were also significantly higher than those of healthy controls (0.642 ± 0.047),with significant difference (all P＜0.01 ),and serum hs-CRP levels on 12th day were similar to that in risk factor group (2.514 ± 0.312),with no significant difference ( P＞0.05 ).Serum HMGB1 levels in risk factor group were higher than those in healthy control group but with no significant difference (P＞0.05),and serum hs-CRP levels were significantly higher than those in healthy control group ( P＜0.01 ).The levels of HMGB1 and hs-CRP in serum were similar between patients with cerebral infarction in vertebral basilar system (n =17) and internal carotid artery system (n =23 ),and the result showed that the serum HMGB1 or hs-CRP levels had no correlation with infarct site,but had significantly positive correlations with the National Institute of Health stroke scale (NIHSS) score (r1=0.377,P1=0.034; r2=0.353,P2=0.025).In addition,there was a positive correlation between levels of serum HMGB1 and hs-CRP (r=0.428,P=0.047).Conclusions Inflammatory mediators including HMGB 1 and hs-CRP might play important roles in the pathogenesis of ACI.They were positively correlated with the severity of ACI,while not correlated with infarct sites.Serum hs-CRP levels in ACI could be of value in early diagnosing of cerebral infarction.Serial determination of serum HMGB 1 and hs-CRP levels might be helpful to evaluate the severity and prognosis of ACI.