大面积烧伤合并吸入性损伤患者高迁移率族蛋白B1的检测及意义

Detection and significance of HMGB1 levels in patients with extensive burns complicated by inhalation injury

目的探讨大面积烧伤合并吸入性损伤患者高迁移率族蛋白B1(HMGB1)的表达及意义。方法 31例大面积烧伤合并吸入性损伤患者为实验组,另选10名健康体检者作为对照组。用酶联免疫吸附法(ELISA)测定对照组血清、患者伤后1、3、7d血清及肺泡灌洗液(BALF)中HMGB1水平,记录患者伤后1、3、7d用力肺活量及肺损伤评分。结果实验组伤后1、3、7d血清中HMGB1水平显著高于对照组(P<0.05);患者血清中HMGB1水平在伤后3天最高,伤后7天有所下降,伤后1、3、7d差异有统计学意义(均P<0.05);BALF中HMGB1水平逐渐升高,伤后1、3、7d差异有统计学意义(均P<0.05);实验组伤后用力肺活量降低,肺损伤评分增加,伤后1、3、7d差异有统计学意义(均P<0.05);BALF中HMGB1水平与用力肺活量呈负相关(P<0.05),与肺损伤评分呈正相关(P<0.05)。结论 HMGB1在大面积烧伤合并吸入性损伤患者肺损伤的发生及发展中起重要作用,BALF中HMGB1水平可作为诊断与预防大面积烧伤合并吸入性损伤患者肺损伤的参考指标。

Objective To detect significance of HMGB1 levels in patients with extensive burns complicated by in- halation injury. Methods 31 Patients with extensive burns complicated by inhalation injury were served as the experi- mental group, and 10 healthy voluntary served as the control group. ELISA was used to detect the levels of HMGB1 in bronchoalveolar lavage fluid of experimental group on ld,3d and 7d after burned and serum of control group and experi mental group on ld,3d and 7d after burned. Forced vital capacity （FVC） and lung injury score （LIS） were recovered in experimental group on ld, 3d and 7d after burned. Results The levels of serum HMGBlin experimental group on ld,3d and 7d after burned were significantly higher than that in control group（P^0.05）. The levels in serum HMGBlin exper- imental group ld after burned was increased significantly and reached to its peak on3d after burned, fell on7d after burn- ed. The differences of levels of serum HMGB1 on ld after burned were statistically significant as compared with3d and 7d after burned （P〈0.05）.. The experimental group HMGB1 levels in BALF were gradually increased inTd, The differ- ences of levels of HMGB1 in BALF on ld after burned were statistically significant as compared with3d and 7d after burn- ed （P〈0.05）. FVC decrease and L IS increased in experimental group after burned. The differences of FVC and L IS on ld after burned were statistically significant as compared with3d and 7d after burned （P〈0.05）. HMGB1 levels in BALF was negatively correlated with FVC （P〈0.05）, were positively correlated with LIS （P〈0.05）. Conclusion HMGB1 plays an important role in occurrence and development of lung injury. The levels of HMGB1 in BALF can be used as a ref- erence index of lung injury in Patients with extensive burns complicated by inhalation injury.