摘要
目的探讨连续性血液净化(continuous blood purification,CBP)对暴发性心肌炎(fulminant myocarditis,FM)患儿血清高迁移率族蛋白-1(high mobility group box-1,HMGB-1)的影响。方法选取2018年1月至2021年10月接受CBP治疗的FM患儿30例,分别于治疗前、治疗期间(治疗后12、24、48、72 h)采集血液标本,另外选择30例健康体检儿童作为对照组。通过酶联免疫吸附法检测血清HMGB-1浓度,并进一步分析各时间点HMGB-1浓度值与肌酸激酶同工酶-MB(creatine kinase-MB,CK-MB)、心肌肌钙蛋白I(cardiac troponin I,cTnI)、B型钠尿肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)等实验室指标的相关性。结果FM患儿入院时血清HMGB-1浓度明显高于对照组(P<0.001),入院时血清HMGB-1水平用于FM诊断的受试者工作特征曲线下面积为0.972(95%CI:0.940~1.000),敏感度和特异度分别为83.3%和100%。CBP治疗期间HMGB-1浓度明显降低对照组(P<0.001)。在入院时,治疗24、48、72 h时,血清HMGB-1水平与同期血清CK-MB、c Tn I、NT-pro BNP水平均呈正相关性(P<0.05)。结论FM患儿血清HMGB-1表达明显增高,通过CBP治疗可清除血清HMGB-1,减轻持续性心肌损伤。
Objective To investigate the effect of continuous blood purification(CBP)on serum high mobility group box-1(HMGB-1)in children with fulminant myocarditis(FM).Methods From January 2018 to October 2021,30 children with FM and received CBP treatment in our hospital were selected.Blood samples were collected before and during treatment(12h,24h,48h and 72h after treatment).In addition,30 healthy children were selected as control.Serum HMGB-1 concentration was detected by enzyme-linked immunosorbent assay,and the relationship between HMGB-1 concentration and laboratory indexes including creatine kinase-MB(CK-MB),cardiac troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP)at each time point was further analyzed.Results The serum HMGB-1 concentration of FM children at admission was significantly higher than the healthy control group(P<0.001),and the area under the receiver operating characteristic curve of serum HMGB-1 at admission for FM diagnosis was 0.972(95%CI:0.940-1.000),the sensitivity and specificity were 83.3%and 100%,respectively.The serum HMGB-1 level decreased significantly during CBP treatment(P<0.001).The decrease degree of HMGB-1 concentration in the same period was positively correlated with the level of CK-MB,cTnI and NT-probNPs(P<0.001).Conclusion The expression of serum HMGB-1 in children with FM was significantly increased,and CBP treatment can clear serum HMGB-1 and reduce myocardial immune damage.
作者
沈俊妃
范双
张娟
龚霞
SHEN Junfei;FAN Shuang;ZHANG Juan;GONG Xia(Department of Pediatrics,Chongqing Dazu District People's Hospital,Chongqing 402360,China)
出处
《中国分子心脏病学杂志》
CAS
2022年第4期4788-4792,共5页
Molecular Cardiology of China
基金
重庆市科技计划项目(DZKJ,2020ACC1026)。
