摘要
目的探究血高迁移率族蛋白-1(HMGB-1)对创伤所致严重脓毒症患者心功能及预后的预测价值。方法回顾性分析空军军医大学第二附属医院83例创伤所致严重脓毒症患者的临床资料,根据左室射血分数(LVEF)将患者分为A组15例(LVEF<30%)、B组20例(LVEF:30%~50%)和C组48例(LVEF≥50%),比较不同心功能分组患者的APACHEⅡ评分,血HMGB-1、血心肌肌钙蛋白I(cTnI)水平;根据患者研究终点预后状态分为E组(存活)51例和F组(死亡)32例,较不同预后分组患者的LVEF,血HMGB-1、心肌肌钙蛋白I(cTnI)水平;分析血HMGB-1对心功能及预后的预测价值。结果A、B组患者的APACHEⅡ评分、血HMGB-1、cTnI水平分别为(27.39±1.56)分、(15.23±0.52)ng/mL、(4.18±0.62)ng/mL和(18.58±1.49)分、(10.96±0.49)ng/mL、(2.57±0.53)ng/mL,均明显高于C组[(12.36±1.22)分、(5.82±0.38)ng/mL、(0.97±0.41)ng/mL],差异均有统计学意义(P<0.05),且A组上述各指标均明显高于B组,差异均有统计学意义(P<0.05)。E组LVEF为(54.39±3.14)%,明显高于F组[(35.62±4.27)%],血HMGB-1、cTnI水平为(5.71±1.05)、(1.04±0.08)ng/mL,均明显低于F组[(11.27±1.36)、(3.39±0.07)ng/mL],差异均有统计学意义(P<0.05)。经Pearson分析,血HMGB-1表达与LVEF呈负相关(r=-0.735,P<0.001),与血cTnI表达呈正相关(r=0.677,P<0.001);与APACHEⅡ呈正相关(r=0.615,P<0.001)。血HMGB-1和血cTnI诊断严重脓毒症心功能损伤的ROC曲线下面积比较,差异无统计学意义(P>0.05)。结论血HMGB-1可作为评估创伤性严重脓毒症患者心功能及预后的重要指标。
Objective To explore the predictive value of blood high mobility group protein-1(HMGB-1)on cardiac function and prognosis in patients with severe traumatic sepsis.Methods The clinical data of 83 patients with severe sepsis caused by trauma in the Second Affiliated Hospital of Air Force Military Medical University were retrospectively analyzed.According to the left ventricular ejection fraction(LVEF),the patients were divided into group A(15 cases,LVEF<30%)and group B(20 cases,LVEF 30%~50%)and group C(48 cases,LVEF≥50%).The APACHEⅡscore,blood HMGB-1 and blood myocardial troponin I(cTnI)levels of patients in different cardiac function groups were compared.According to the prognostic status of the end points of the study,the patients were divided into group E(survival)with 51 cases and group F(death)with 32 cases.The levels of LVEF,HMGB-1 and cardiac troponin I(cTnI)in patients with different prognostic groups were compared.To analyze the predictive value of HMGB-1 in cardiac function and prognosis.Resluts The APACHEⅡscore,blood HMGB-1 and cTnI levels of patients in groups A and B were(27.39±1.56)points,(15.23±0.52)ng/mL,(4.18±0.62)ng/mL and(18.58±1.49)points,(10.96±0.49)ng/mL,(2.57±0.53)ng/mL,respectively,which were significantly higher than those in group C[(12.36±1.22)points,(5.82±0.38)ng/mL,(0.97±0.41)ng/mL],the differences were statistically significant(P<0.05),and the above indicators in group A were significantly higher than those in group B,and the differences were statistically significant(P<0.05).The LVEF of group E was(54.39±3.14)%,which was significantly higher than that of group F[(35.62±4.27)%],the levels of HMGB-1 and cTnI in group E were(5.71±1.05)and(1.04±0.08)ng/mL,which were significant lower than those in group F[(11.27±1.36),(3.39±0.07)ng/mL],the differences were statistically significant(P<0.05).By Pearson analysis,HMGB-1 expression was negatively correlated with LVEF(r=-0.735,P<0.001),and positively correlated with cTnI expression(r=0.677,P<0.001),positively correlated wit
作者
张毳毳
白和平
吕晓燕
ZHANG Cui-cui;BAI He-ping;LYU Xiao-yan(Department of Emergency,Second Affiliated Hospital of Air Force Military Medical University,Xi'an Shaanxi 710038,China;Department of Cardiovascular Surgery,Second Hospital of Yulin City,Yulin Shaanxi 719000,China;Department of Cardiovascular Medicine,Xi'an Ninth Hospital,Shaanxi Xi'an 710054,China)
出处
《临床和实验医学杂志》
2021年第21期2293-2296,共4页
Journal of Clinical and Experimental Medicine
基金
陕西省科技计划发展项目(编号:2019K12-03)。
关键词
严重脓毒症
创伤
高迁移率族蛋白-1
心功能
预后
预测
Severe sepsis
Trauma
High mobility group protein-1
Cardiac function
Prognosis
Predict
