脓毒症患者高迁移率族蛋白1水平与卫气营血辨证、APACHEⅡ评分的相关性研究

Correlation of Serum High-mobility Group Box Protein 1 Level with Defense-Qi-nutrient-blood Syndrome Differentiation and Acute Physiological and Chronic Health Evaluation Ⅱ Score in Sepsis Patients

【目的】探讨不同中医证型脓毒症患者血清高迁移率族蛋白1(HMGB1)水平与急性生理和慢性健康评估Ⅱ(APACHEⅡ)评分、卫气营血辨证分型的相关性。【方法】24例脓毒症患者按卫气营血辨证分为气分证组11例、营血分证组13例,并设8例正常对照组;分别进行APACHEⅡ评分,采用Western blot法检测各组患者血清HMGB1含量,并对HMGB1水平、APACHEⅡ评分及卫气营血辨证证型进行相关性分析。【结果】营血分证组APACHEⅡ评分显著升高,与气分证组比较差异有显著性意义(P<0.01),且不同辨证分型与APACHEⅡ评分呈正相关(P<0.01);气分证组、营血分证组患者血清HMGB1水平较正常对照组显著升高(P<0.05或P<0.01),而营血分证组血清HMGB1水平较气分证组显著升高(P<0.01),且不同辨证分型与血清HMGB1水平、APACHEⅡ评分与血清HMGB1水平均呈正相关(P<0.01)。【结论】脓毒症按卫气营血理论辨证,可反映其病理过程及病情严重程度。

Objective To investigate the serum high-mobility group box protein 1 （HMGB1）level in sepsis patients with different syndrome patterns, and to explore the correlation of HMGB1 level with defense-Qi-nutrientblood syndrome differentiation and Acute Physiological and Chronic Health Evaluation Ⅱ （APACHE Ⅱ ） score. Methods Twenty-four sepsis patients were differentiated as Qi system syndrome （Qs group, N = 11 ） and nutrient-blood system syndrome （NB group, N = 13 ）. Eight healthy volunteers served as the normal control. APACHE Ⅱ score was evaluated, serum HMGB1 level was detected by Western blot method, and the correlation of HMGB1 level with defense-Qi-nutrient-blood syndrome differentiation and APACHE Ⅱ score was analyzed. Results APACHE Ⅱ score was higher in NB group than that in QS group, the difference being significant （P 〈 0. 01 ） ; APACHE Ⅱ score was positively correlated with the syndrome patterns （P 〈0.01 ）. Serum HMGB1 level was higher in QS group and NB group than that in the control group （P 〈0. 05 or P 〈0. 01 , and was higher in NB group than that in QS group （P 〈 0.01 ）. Serum HMGB1 level was positively correlated with the syndrome patterns, and was also positively correlated with APACHE Ⅱ score （P 〈 0.01 ）. Conclusion Syndrome differentiation of sepsis based on the defense-Qi-nutrient-blood theory is practical for reflecting the progress and illness degree of sepsis.