CAJ | 학술논문

目的：探讨TBI患儿早期外周血HMGB1表达变化及其临床意义。方法将87例急性TBI患儿根据格拉斯哥评分分成三组院严重组(≤8分)、中度组(9~12分)、轻度组(13~15分)，分别在伤后3 h、6 h、12 h、24 h、48 h采集静脉血，采用酶联免疫吸附试验(ELISA)检测血清HMGB1含量；同时根据严重组患儿28 d内是否死亡、是否发生脓毒症或急性肺损伤分组，比较组间HMGB1的表达。结果重度组在各时间点HMGB1水平均显著高于轻、中度组(P<0.01)；中度损伤组较轻度损伤组在6 h、12 h、24 h、48 h明显升高(P<0.01)；死亡组患者血清HMGB1水平较存活组显著升高(P<0.01)；发生脓毒症及急性肺损伤病例血清HMGB1显著均高于未发生脓毒症及急性肺损伤病例(P<0.01)。结论颅脑损伤患儿早期血清HMGB1即升高，且可能作为一种“预警信号”预测损伤严重度及预后、并发症的发生。
목적：탐토TBI환인조기외주혈HMGB1표체변화급기림상의의。방법장87례급성TBI환인근거격랍사가평분분성삼조원엄중조(≤8분)、중도조(9~12분)、경도조(13~15분)，분별재상후3 h、6 h、12 h、24 h、48 h채집정맥혈，채용매련면역흡부시험(ELISA)검측혈청HMGB1함량；동시근거엄중조환인28 d내시부사망、시부발생농독증혹급성폐손상분조，비교조간HMGB1적표체。결과중도조재각시간점HMGB1수평균현저고우경、중도조(P<0.01)；중도손상조교경도손상조재6 h、12 h、24 h、48 h명현승고(P<0.01)；사망조환자혈청HMGB1수평교존활조현저승고(P<0.01)；발생농독증급급성폐손상병례혈청HMGB1현저균고우미발생농독증급급성폐손상병례(P<0.01)。결론로뇌손상환인조기혈청HMGB1즉승고，차가능작위일충“예경신호”예측손상엄중도급예후、병발증적발생。
Objective To investigate the serum high mobility group box-1 protein level of children's patients with a-cute traumatic brain injury and it's expression changes and clinical significance. Methods A total of 87 children's patients with acute traumatic brain injury were randomly divided into three groups: severe group (≤8 scores), moderate group(9 to 12 scores) and minor group(13 to 15 scores) according to the patients' Glasgow Coma Scale on admission. Their venous blood were drawn at 3 h, 6 h, 12 h, 24 h, 48 h after injury and the serum HMGB1 were determined by en zyme linked immunosorbent assay(ELISA). The serum HMGB1 concentration were compared between different groups, survivors and non-survivors in 28 days, patients who developed acute lung injury(ALI) or sepsis and who did not deve-lope ALI or sepsis in severe injury group. Results Compared with the minor and moderate group, the serum HMGB1 level in severe group were significantly elevated at each time points(P<0.01). At 6 h, 12 h, 24 h, 48 h time points, the serum HMGB1 level in the moderate group increased significantly compared with the minor group (P<0.01). The serum HMGB1 levels at 24 h after injury were higher in non-survivors compared with survivors (P<0.01). The serum HMGB1 levels in those patients who developed acute lung injury (ALI) or sepsis were higher than who did not develope ALI or sepsis (P<0.01). Conclusion The serum HMGB1 concentration is increased early and may be a ‘alarm signal'prog-nosticating prognosis and complication after acute traumatic brain injury in children.