慢性肾衰竭患者腹水高迁移率族蛋白检测及其意义

Detection of ascitic fluid HMGB1 in patients with chronic renal failure and its significance

目的研究高迁移率族蛋白B1(HMGB1)在慢性肾衰竭及并发感染患者腹水中的水平变化及其临床意义。方法采用ELISA法对35例临床腹水标本(其中慢性肾衰竭无并发症10例,肾衰竭并发肺炎12例,肾衰竭并发腹膜炎13例)进行HMGB1检测,同时检测所有研究对象血液中的CRP水平。结果肾衰竭并发腹膜炎(C)组腹水(渗出液)HMGB1水平明显高于慢性肾衰竭无并发症(A)组及肾衰并发肺炎(B)组(漏出液),差异有统计学意义(P<0.01),A组与B组腹水中HMGB1水平的差异无统计学意义;B组和C组血液中的CRP水平明显高于A组,差异有统计学意义(P<0.01),提示体内存在感染。结论腹水HMGB1检测对慢性肾衰竭患者腹水性质的鉴别有较好的临床意义,若联合血液CRP指标的检测对临床鉴别诊断慢性肾衰竭有无并发其他感染性疾病也具有一定意义。

OBJECTIVE To investigate the clinical significance of HMGB1 level in ascitic fluid from chronic renal failure patients complicated with infection.METHODS HMGB1 level were detected by ELISA in ascitic fluid of 10 chronic renal failure patients without infection（group A）,12 with pneumonia（group B） and 13 with peritonitis（group C）.Serum CRP were also detected in all 35 chronic renal failure patients.RESULTS The average level of HMGB1 in exudates（group C） was significantly higher than transudates（including group A and B）（P0.01）.There were no significant difference between group A and B.Compared to group A,the CRP concentration increased apparently in group B and C（P0.01）,which suggested infection in body.CONCLUSION It shows potential clinical significance to differentiate the ascitic fluid types of chronic renal failure patients by detection ascitic fluid HMGB1.And it may also be helpful to judge whether the chronic renal failure patients complicated with other infectious diseases if combined with the detection of CRP.