CAJ | 학술논문

目的：探讨北方地区蝮蛇咬伤患者血清高迁移率族蛋白B1（ HMGB1）水平的变化及临床意义。方法将87例北京及周边省市来我院就诊的蝮蛇咬伤中毒患者，根据毒蛇咬伤的临床分型及严重程度评分标准分成轻型、重型、危重型三组，分别于伤后就诊当天（未进行任何治疗前），就诊第2天和第7天采集静脉血标本各三份，另以30名健康体检者的血清作为正常对照组，采用酶联免疫吸附剂测定法（ ELISA）测定不同时期血清HMGB1水平，各组之间比较并进行统计学分析。结果不同时期蝮蛇咬伤患者的血清HMGB1水平均高于正常对照组（ P＜0.05）；重型高于轻型，危重型中毒组患者明显高于轻型和重型中毒组患者（P＜0．05）；轻型、重型就诊第2天血清HMGB1水平明显高于就诊当天，第7天血清 HMGB1水平较第2天明显下降（ P＜0.05），但仍高于就诊当天（ P＞0．05）。危重型就诊第2天血清HMGB1水平较就诊当天升高（P＞0．05），第7天血清HMGB1水平仍高于就诊当天，较第2天下降，但差异均无统计学意义（P＞0．05）。结论北方地区蝮蛇咬伤患者血清HMGB1水平均明显升高，它可能协同参与了蝮蛇咬伤中毒患者的病情发生、发展过程，其升高水平可以作为反映中毒严重程度的参考指标。动态观察其水平的变化可以指导蛇咬伤患者的治疗，帮助判断患者的预后。
목적：탐토북방지구복사교상환자혈청고천이솔족단백B1（ HMGB1）수평적변화급림상의의。방법장87례북경급주변성시래아원취진적복사교상중독환자，근거독사교상적림상분형급엄중정도평분표준분성경형、중형、위중형삼조，분별우상후취진당천（미진행임하치료전），취진제2천화제7천채집정맥혈표본각삼빈，령이30명건강체검자적혈청작위정상대조조，채용매련면역흡부제측정법（ ELISA）측정불동시기혈청HMGB1수평，각조지간비교병진행통계학분석。결과불동시기복사교상환자적혈청HMGB1수평균고우정상대조조（ P＜0.05）；중형고우경형，위중형중독조환자명현고우경형화중형중독조환자（P＜0．05）；경형、중형취진제2천혈청HMGB1수평명현고우취진당천，제7천혈청 HMGB1수평교제2천명현하강（ P＜0.05），단잉고우취진당천（ P＞0．05）。위중형취진제2천혈청HMGB1수평교취진당천승고（P＞0．05），제7천혈청HMGB1수평잉고우취진당천，교제2천하강，단차이균무통계학의의（P＞0．05）。결론북방지구복사교상환자혈청HMGB1수평균명현승고，타가능협동삼여료복사교상중독환자적병정발생、발전과정，기승고수평가이작위반영중독엄중정도적삼고지표。동태관찰기수평적변화가이지도사교상환자적치료，방조판단환자적예후。
Objective To explore the dynamic changes and clinical manifestations of serum high mobility group protein B 1 of Agkistrodon Halys bite patients in north China .Methods According to clinical classification and severity grade of snake bites , we divided 87 Agkistrodon Halys bite poisoning cases into three groups:mild, severe and critical type .These patients were from Beijing or its surrounding provinces .We extracted intravenous blood of three different stage of the treatment: before treatment, two days after treatment and seven days after treatment .We also compared them to 40 healthy samples, using Enzyme -linked immunosorbent assay ( ELISA ) method to determinate the serum HMGB1 level in different periods .Finally we compared the differences between each group and analyzed the results with statistical methods .Results The serum HMGB1 levels of all the three groups of Agkistrodon Halys bite patients were higher than those normal samples (P<0.05).Serum HMGB1 in severe group was higher than that in the mild group .Serum HMGB1 in critical group was significantly higher than that in the other two groups (P<0.05).For the mild and the severe groups, the Serum HMGB1 levels after two days of treatment were significantly higher than those before treatment .The levels of serum HMGB1 after seven -day treatment were decreased significantly compared with those after tow -day treatment (P <0.05).Although decreased, the levels of HMGB1 after seven -day treatment were still higher than those before treatment (P>0.05).For the critical groups, the levels of serum HMGB1 after two-day treatment were higher than those before treatment ( P>0 .05 ) .And the levels of serum HMGB1 after seven -day treatment were still higher than those before treatment , but were not significantly lower than those of two -day treatment (P>0.05).Conclusion The levels of serum HMGB1 of Agkistrodon Halys bite patients in north China increase significantly .HMGB1 may be involved in the Agkistrodon Halys bite patient's condition occurs and development process .It can serve as a reference index which reflects the severity of poisoning .Dynamic observation of HMGB1 can guide the treatment of Agkistrodon Halys bite patients , and help determine the prognosis of patients .