ACI患者血浆高迁移率族蛋白B1的检测及临床意义

摘要

目的:检测急性脑梗死(ACI)患者血浆高迁移率族蛋白B1(HMGB1)浓度,分析其与预后的相关性.方法:50例体检健康人静脉血在体检时获得,90例ACI患者静脉血在入院时获得.ELISA测定血浆高迁移率族蛋白B1浓度,统计分析其与预后的相关性.结果:ACI患者血浆HMGB1浓度(8.4±3.8)ng/ml显著高于体检健康者(1.2±0.4)ng/ml(P<0.01),与美国国立卫生院神经功能缺损评分显著正相关(r=0.591,P<0.01),是ACI患者3个月内死亡的独立危险因素(OR=1.892,95%CI=1.145～5.439,P<0.01),可显著预测ACI患者3个月内死亡(曲线下面积=0.842,95%CI=0.772~0.917,P<0.01),其浓度＞8.6 ng/ml,对预测ACI患者3个月内死亡有84.2%的灵敏度和77.4%的特异度.结论:ACI后血浆HMGB1浓度升高,与ACI患者不利的临床预后相关.%Objective To determine plasma high mobility group box l(HMGBl) level in patients with acute cerebral infarction (ACI) and analyze its association with disease outcome. Methods Venous blood samples were obtained on admission in 90 patients with ACI and on entry in 50 healthy controls. Plasma HMCB1 concentration was measured by EUSA. Its conelation with disease outcome was analyzed statistically. Results The plasma HMGB1 level (8.4 ±3.8 ng/ml) in patients was significantly higher than that (1.2 ±0.4 ng/ml) in healthy controls ( P <0. 01), positively correlated to national institutes of health stroke scale score (r = 0.591 ,P<0.01), and identified as an independent predictor for 3-month mortality (OR = 1.892, 95% CI =1. 145～5.439, P< 0.01). Its level of more than 8.6 ng/ml predicted 3-month mortality with 84.2% sensitivity and 77.4% specificity ( area under curve = 0.842, 95% CI =0.772～0.917, P<0.01)individually. Conclusion Increased plasma HMGB1 level is found after cerebral infarction, in association with a poor clinical prognosis.