HMGB1和pro-BNP在心力衰竭进展期中的动态变化

Dynamic change rule of HMGB1 and pro-BNP in progress period of patients with heart failure

目的探讨HMGB1和pro-BNP在心力衰竭患者不同时期血清中的动态变化规律。方法选择心力衰竭患者54例,男31例,女23例,平均年龄66.7岁。其中心力衰竭A期16例,心力衰竭B期14例,心力衰竭C期12例,心力衰竭D期12例。并在心力衰竭C期和D期的患者中选择18例,进行动态观察。设心功能正常对照组20例,采用酶联法测定HMGB1和pro-BNP。结果心力衰竭患者HMGB1和pro-BNP等指标较正常对照组均显着升高。在心力衰竭进展的分期各组中HMGB1,pro-BNP等指标随心力衰竭程度的加重而增高,病情愈严重HMGB1,pro-BNP等指标增高越明显,以心力衰竭D期为明显(P<0.05)。心力衰竭早期以HMGB1增高明显,中晚期以pro-BNP增高为明显。在心力衰竭C期和D期二组患者的动态观察中,治疗后HMGB1和pro-BNP下降明显,以pro-BNP早期为明显(P<0.05)。血清HMGB1与pro-BNP水平的相关性(r=0.63)。结论 HMGB1和pro-BNP在心力衰竭发生发展过程中发挥着重要作用,心力衰竭早期以HMGB1增高明显,中晚期以pro-BNP增高为明显。HMGB1和pro-BNP血清水平的增高对心力衰竭的诊断,病情评估有着重要意义。

Objective To analyze the dynamic change rule of HMGB1 and pro - BNP in progress period of patients with heart failure. Methods 54 patients with heart failure （31men and 23 women, mean age66.7 years） were divided into heart failure periods ： heart failure period A（n=16）, heart failure period B（n=14）, heart failure period C（n=12）, heart failure period D（n=12）. 18 eases in heart failure period C and D were choosen for dynamic observation. 20 eases of cardiac function in normal were selected as control group. They were measured serum HMGB1 and pro - BNP level by radiommunoassay at all. Results Compared with normal control group, heart failure patients＇ serum HMGB 1 and pro - BNP level were significantly increased. In the progression of heart failure in installment groups, the serum HMGB1 and pro - BNP indicators such as the deterioration of the heart failure degree was the higher,the more serious HMGB1 and pro - BNP index obviously increased, such as heart failure period D for signifieantly（P 〈 0.05）.In the early stage of heart failure, HMGB1 was significantly increased, and pro-BNP increased in the middle and later stage. In patients with heart failure period C and D two groups of dynamic observation, serum HMGB1 and pro - BNP decreased significantly after treatment, early in serum pro - BNP was obvious. （P 〈 0.05）.The correlation between serum HMGB1 levels and pro - BNP levels（r=0.63）. Conclusion Serum HMGBI and pro - BNP plays an important role in the process of heart failure development. In the early stage of heart failure, HMGB1 is significantly increased,and pro-BNP is increase in the middle and later stage. The increased serum levels of HMGB1 and pro-BNP in the diagnosis of heart failure and condition assessment has important significance.