摘要
目的探讨血清高迁移率族蛋白B1(HMGB-1)与急性病生理学与长期健康评估评分(APACHE-Ⅱ评分)在急性胰腺炎(AP)严重程度及其对预后的评估价值。方法收集急性胰腺炎(AP)患者60例,其中轻症急性胰腺炎组(MAP组)20例,中度急性胰腺炎组(MASP组)20例,重症急性胰腺炎组(SAP组)20例。分别在入院后第1、3、7天动态监测各组患者的HMGB-1水平,分析其与AP严重程度及与APACHE-Ⅱ评分的关系。按患者临床结局将其分为存活组(48例)及死亡组(12例),分析HMGB-1与APACHE-Ⅱ评分对急性胰腺炎患者预后的评估价值。结果 MAP组患者第1、3、7天HMGB-1值分别为(2.16±0.35)、(3.44±0.96)、(1.21±0.33)μg/L,MSAP组患者第1、3、7天HMGB-1值分别为(4.78±1.32)、(10.45±2.36)、(3.92±1.55)μg/L,SAP组患者第l、3、7天HMGB-1值分别为(14.12±2.64)、(27.53±8.19)、(11.34±2.57)μg/L。SAP组患者中HMGB-1明显高于MAP组与MSAP组,差异有统计学意义(P<0.05);MSAP组与MAP组的HMGB-1水平差异也有统计学意义(P<0.05)。SAP组随着△3-1HMGB1(第3天与第1天的HMGB1差值)的增加,第3天APACHE-Ⅱ评分亦增加,两者呈明显正相关(r=0.725,P<0.05),MSAP组与MAP组随着HMGB-1值的增加,APACHE-Ⅱ评分无明显变化(r=0.127、0.114,P>0.05)。死亡组HMGB-1水平及APACHE-Ⅱ评分显著高于存活组(P<0.05)。结论血清HMGB1水平与APACHE-Ⅱ评分具有较好的相关性,二者联合可作为预测急性胰腺炎患者病情严重程度及预后的敏感指标。
Objective To observe the evaluation value of serum high mobility group protein BI（HMGB-1） and APACHE Ⅱ score in severity degree and prognosis of the patients with acute pancreatitis（AP）. Methods Sixty patients with AP were collected, including 20 cases in the mild AP group（MAP）,20 cases in moderate AP group（MSAP） and 20 cases in the severe AP group （SAP）. The HMGB-1 level in each group was dynamically monitored on 1,3,7 d after admission and its relationship with AP severity and APACHE Ⅱ score was analyzed. According to clinical outcomes,these cases were divided into the survival group（48 cases） and death group（12 cases）,and the value of serum HMGB-1 level and APACHE-Ⅱ scores for evaluating the prognosis was analyzed. Results The HMGB-1 values on 1,3,7 d in the MAP group were（2. 16±0.35）, （4.34±0.96）, （1.21±0.33）μg/L respec- tively, which in the MSAP gro up were （ 7.78 ± 1.32 ）, （ 10.45 ± 2.36 ）, （ 6.92 ± 1.55 ）μg/L respectively, and which in the SAP gro up were（14.12 ±2.64）, （27.53 ± 8.19）, （ 11.34 ± 2.57） μg/L respectively. The HMGB-1 levels in the SAP group were significantly higher than those in the MAP group and MSAP group, the differences were statistically significant （P〈 0. 01, P〈0. 05）;the HMGB-1 level had statistical difference between the MSAP group and MAP group（P〈0, 05）;the HMGBll score on 3 d in the SAP group was increased with A3-1 HMGB1 increas（ difference value of HMGB1 on 1,3 d ） ,the both showed the positive correla- tion（r=0. 725 ,P〈0.05）. But the APACHE-]I score in the MSAP and MAP groups had no obvious change with the HMGB-1 lev- el increase,the difference was not statisticall）; significant（r=0. 127,0. 114, P〈0.05）. Serum HMGB1 level and APACHE-Ⅱ score in the death group were significantly higher than those in the survival group（P〈0.05）. Conclusion The serum HMGB1 level has good correlation with APACHE-Ⅱ score in AP;their combination can serve the sensitive indicator fo
出处
《重庆医学》
CAS
北大核心
2017年第17期2350-2352,共3页
Chongqing medicine
基金
重庆市卫生和计划生育委员会基金项目(ZY20150247)
关键词
胰腺炎
急性病
高迁移率族蛋白B1
急性病生理学与长期健康评估
pancreatitis
acute disease ~ high mobility group boxprotein 1
acute physiology and chronic health evaluation
