HMGB1与炎性因子在脊髓损伤患者血清中的表达及临床意义

Expression and clinical significance of serum HMGB1 and inflammatory factors in patients with spinal cord injury

目的探讨高迁移率族蛋白1(HMGB1)在脊髓损伤患者血清中的表达及其临床意义。方法收集2007年1月至2014年1月在新疆维吾尔自治区阿克苏市兵团第一师医院就诊的87例脊髓损伤患者作为脊髓损伤组,脊髓损伤的严重程度根据美国脊髓损伤协会(ASIA)残损分级进行评估,分别于脊髓损伤后1、3、7d行静脉采血,另外取87例健康成年人血清做对照组,酶联免疫吸附试验检测患者血清中HMGB1、白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)水平,并分析HMGB1与IL-1β、IL-6、TNF-α的相关性及患者损伤程度的关系。结果脊髓损伤组伤后1、3、7d的HMGB1、IL-6、IL-1β和TNF-α水平均较高。脊髓损伤患者血清中HMGB1和IL-6水平在损伤后1d明显升高,在3d时水平达峰值;IL-1β和TNF-α在伤后1d最高,3、5d后逐渐降低。相关性分析表示伤后1、3d中HMGB1水平与IL-6、IL-1β和TNF-α水平呈正相关(P<0.05)。髓损伤后1、3d,患者血清中HMGB1水平与脊髓损伤的严重程度密切相关(P<0.05),脊髓损伤的程度越重,患者血清中的HMGB1水平越高。结论 HMGB1在早期脊髓损伤患者血清中的水平显著升高,并可作为早期脊髓损伤严重程度的评估指标之一。

Objective To investigate the expression and clinical significance of serum high-mobility group box I（HMGB1） in the patients with spinal cord injury （SCI）. Methods A total of 87 cases of acute SCI treated in the Aksu Corps First Division Hos- pital from January 2007 to January 2014 were collected as the SCI group. The SCI severity was evaluated according to the damage grade by the American Spinal Cord Injury Association（ASIA）. Venous blood was collected on 1,3,7 d after SCI. Other 87 healthy adults served as the control group. The expression levels of serum HMGB1, interleukin-6 （IL-6）, IL-1β and tumor necrosis factor alpha （TNF-α） in the two groups were measured by ELISA. Then the correlation between the HMGB1 expression level with IL-1β, IL-6 and TNF-α and the relation between HMGB1 with SCI severity were analyzed. Results The HMGBI,IL-6,IL-1 and TNF-a levels on 1,3,7 d after SCI in the SCI group were higher. The expression levels of serum HMGB1 and IL-6 on 1 d after SCI in the SCI patients were signiSicantly increased,and reached the peak value on 3 d; the levels of IL-1β and TNF-a on 1 d after SCI were highest,and gradually decreased on 3,5 d. The correlation analysis showed that the expression levels of HMGB1 on 1,3 d after SCI were positively correlated with the IL-6, IL-1β and TNF-α expression levels（P〈0, 05）. The serum HMGB1 expression level on 1,3 d after SCI was closely correlated with the SCI severity （P〈0.05）. The severe the SCI severity,the higher the serum HMGB1 ex- pression level. Conclusion The expression level of serum HMGB1 in the patients with early SCI is significantly increased,and can be used as one of indicators for assessing the severity of early SCI.