CAJ | 학술논문

目的探讨血清高迁移率族蛋白1 (HMGB1)在HBV相关的慢加急性肝衰竭(HBV-ACLF)患者中的特点及其临床意义.方法对60例HBV-ACLF患者血清HMGB1水平进行检测分析,并与30例慢性乙型肝炎患者和24例健康查体者进行对照研究,分析其与患者肝功能生物化学指标的相关性,并分析其与患者预后的关系.两组间比较采用独立样本的t检验或非参数检验,多组间比较采用方差分析,相关性分析采用多元线性回归法.结果 HBV-ACLF患者血清HMGB1水平高于慢性乙型肝炎患者[(10.03±3.08) μg/L比对(7.47+2.06) μg/L,t=2.667,P＜0.01],晚期HBV-ACLF患者血清HMGB1水平高于早期患者[(11.68±1.93) μg/L比对(9.11±3.15)μ g/L,t=2.214,P＜0.01],HBV-ACLF患者血清HMGB1水平与AST水平呈正相关(r=0.655,P＜0.01).随访2个月,感染组患者的HMGB1水平高于非感染组[(11.85±2.21)μ g/L比对(9.83±2.75) μg/L,Z=4.027,P＜0.05],死亡组患者的HMGB1水平高于生存组[(11.03±2.31)μg/L比对(9.52±3.01)μg/L,t=2.428,P＜0.05].结论 HBV-ACLF患者血清HMGB1水平随病情进展呈进行性升高,并可部分预测HBV-ACLF患者的预后.
목적 탐토혈청고천이솔족단백1 (HMGB1)재HBV상관적만가급성간쇠갈(HBV-ACLF)환자중적특점급기림상의의.방법 대60례HBV-ACLF환자혈청HMGB1수평진행검측분석,병여30례만성을형간염환자화24례건강사체자진행대조연구,분석기여환자간공능생물화학지표적상관성,병분석기여환자예후적관계.량조간비교채용독립양본적t검험혹비삼수검험,다조간비교채용방차분석,상관성분석채용다원선성회귀법.결과 HBV-ACLF환자혈청HMGB1수평고우만성을형간염환자[(10.03±3.08) μg/L비대(7.47+2.06) μg/L,t=2.667,P＜0.01],만기HBV-ACLF환자혈청HMGB1수평고우조기환자[(11.68±1.93) μg/L비대(9.11±3.15)μ g/L,t=2.214,P＜0.01],HBV-ACLF환자혈청HMGB1수평여AST수평정정상관(r=0.655,P＜0.01).수방2개월,감염조환자적HMGB1수평고우비감염조[(11.85±2.21)μ g/L비대(9.83±2.75) μg/L,Z=4.027,P＜0.05],사망조환자적HMGB1수평고우생존조[(11.03±2.31)μg/L비대(9.52±3.01)μg/L,t=2.428,P＜0.05].결론 HBV-ACLF환자혈청HMGB1수평수병정진전정진행성승고,병가부분예측HBV-ACLF환자적예후.
Objective To evaluate the levels of high mobility group box 1 protein (HMGB 1) in serum of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and investigate its potential relation to the clinical features of these patients.Methods Sixty patients with HBV-related ACLF,30 patients with chronic hepatitis B (CHB),and 24 healthy individuals (controls) were enrolled in the study.Markers of liver function,such as aspartate aminotransferase (AST),were measured by routine biochemical methods.Imaging studies,such as abdominal computed tomography or magnetic resonance imaging,were used for disease staging.Serum levels of HMGB1 were measured by ELISA.Deaths within the 2-month follow-up after serum collection were used for the survival anlaysis.Patients who developed peritonitis,pneumonia,or other bacterial and fungal infections during the 2-month follow-up after serum collection were classified as the infected group.Pairwise comparisons were carried out by t-test,and multiple comparisons were carried out by analysis of variance.Results Patients with HBV-related ACLF had significantly higher serum levels of HMGB1 than CHB patients or controls (P =0.003).Among the patients with HBV-related ACLF,those in the late stage (n =20) had significantly higher levels of HMGB 1 than those in the early stage (n =20) (P =0.005).The serum levels of HMGB 1 correlated well with AST level in patients with HBV-related ACLF (P =0.006).In addition,patients with HBV-related ACLF who developed infection or died during follow-up also had significantly higher levels of HMGB1 (P =0.028 or P =0.017,respectively).Conclusion Enhanced serum level of HMGB 1 is associated with development of HBV-related ACLF in CHB patients.The strong correlation between HMGB1 and AST levels suggest that HMGB1 may be useful as a prognostic marker for development of ACLF.