高迁移率族蛋白-1浓度变化与脓毒症预后关系.pdfVIP

to September,2009, 56 sepsis patients without multiple organ dysfunction syndromes were included in a prospective study.Patients were excluded if age less than 18 years old,in final stage of chronic diseases,suffering from two or more organs dysfunction within 3 days,acute pancreatitis without infection,due to other medical reasons whose expected survival was less than 28 days. Finally,45 patients were included in the further analysis.Peripheral blood samples were collected on days 0, 1, 3, 7.HMGB- 1 levels were measured by ELISA in the supernatant after centrifuge. SOFA scores and APACHE Ⅱscores were recorded everyday.Patients’ prognoses were assessed during the 28-day follow-up period.According to the survival condition within the 28-day period, the patients were divided into surviva l group and non-survival group.HMGB- 1 levels between the two groups were compared by Students t-test.Spearman rank correlation is used to analyze the correlation between HMGB- 1 levels and SOFA as well as APACHE Ⅱ.The effect on predicting survival within the 28-day period in the selected parameter by receiver operating characteristic curves (ROC curves). Results: There was no significant difference in plasma HMGB- 1 levels on day 0,1,3,7 between the survival group and non-survival group (P all0.05).The difference in the concentration of HMGB- 1 between 3 d and 0 d (Δ3-0HMGB- 1) in plasma of the non-survival group was significantly low er than that of survival group.ROC curves area of Δ3-0 HMGB- 1 is 0.868±0.061 (P ＝0.000，95% CI 0.748～0.988) for predicting 28-day survival.The optimal cut-off point was 2.72 ng/mL, and the sensitivity and specificity were 81.8% and 86.7% at this time, respectively.Δ3-0HMGB- 1 is negatively correlative to SOFA on days 1,2,3,4 (P all ＜0.01).