[目的]探讨血清高迁移率组蛋白B1(HMGB1)作为特发性肺动脉高压(IPAH)患者生物标志物的可行性及临床价值.[方法]收集2011年5月至2015年4月中南大学湘雅二医院住院及门诊的IPAH患者33例,并对8例使用肺动脉高压靶向药物治疗的IPAH患者随访6个月.采用酶联免疫法(ELISA)测定血清HMGB1浓度.[结果]IPAH患者血清HMGB1水平(ng/mL)显著高于健康成人对照组(14.8±2.4 vs.3.8±1.2,P<0.001).IPAH患者血清HMGB1水平与平均肺动脉压力、肺血管阻力呈显著正相关(r=0.460,P=0.002;r=0.541,P=0.001).8例IPAH患者使用肺动脉高压靶向药物治疗6月后,在肺动脉压力(mmHg,62.3±9.7 vs.54.0±8.7,P<0.001)和6 min步行试验(m)得到改善的同时(368±69 vs 401±55,P<0.001),血清HMGB1水平(ng/mL)显著降低(15.9±5.3 vs.11.1±2.5,P=0.021).[结论]检测血清HMGB1水平可在一定程度上反映肺动脉高压靶向药物的治疗效果,有望成为IPAH患者重要的随访指标.%[Objective]To estimate the clinical value of serum high mobility group box 1(HMGB1) as a biomarker of idiopathic pulmonary arterial hypertension (IPAH).[Methods]This study included 33 patients with IPAH that were confirmed by right heart catheter in the Second Xiangya Hospital, Central South University from May 2011 to April 2015. 8 patients with IPAH were followed up for 6 months during treating with PAH-specific pharmacotherapies. All the subjects ' clinical data were collected,HMGB1 levels were determined by enzyme linked immunosorbent assay(ELISA).[Results]Serum HMGB1 levels (ng/mL) were significantly increased in patients with IPAH compared with the control group(14.8 ± 2.4 vs. 3.8 ± 1.2, P<0.001);The serum HMGB1 levels were significant?ly positive correlation with mean pulmonary arterial pressure(MPAP) and pulmonary vascular resistauce (PVR) ( r=0.864, P<0.001; r=0.460,P=0.002) in the patients with IPAH. After treating with PAH-specific pharmacotherapies for 6 month, HMGB1 levels(ng/mL) were significantly decreased(15.9±5.3 vs 11.1±2.5,P=0.021)along with the patients'MPAP(62.3±9.7 vs 54.0±8.7,mmHg)and 6-min walk distances(m)improved(368±69 vs 401±55,P<0.001).[Conclusions]Our study suggested that serum HMGB1 may be used as a biomarker of treatment response to targeted therapy, and it will be used as a biomarker in the follow-up evaluation of patients with IPAH.
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