HMGB⁃1、cTnI及Ang2与急诊多发伤血管损伤、院内死亡风险的关系

The relationship between the levels of HMGB-1,cTnI and Ang2,vascular endothelial injury and the risk of hospital death in patients with multiple injuries in the emergency department

目的探讨高迁移率蛋白⁃1(HMGB⁃1)、肌钙蛋白Ⅰ(cTnI)及血管生成素2(Ang2)水平变化与急诊多发伤患者血管内皮损伤及院内死亡风险的关系。方法选取2017年1月-2020年12月本院收治的95例急诊多发伤患者设为观察组(重伤组44例、轻伤组例51例),选取同期在本院进行健康体检的98例健康者设为对照组。比较各组之间HMGB⁃1、cTnI、Ang2水平,采用Pearson直线相关分析HMGB⁃1、cTnI、Ang2水平与血浆血栓调节蛋白(TM)、冯维尔布兰德因子(vwF)之间的相关性,并观察患者预后情况。结果观察组HMGB⁃1、cTnI、Ang2水平均显著高于对照组,差异均有统计学意义(P<0.05)。重伤组HMGB⁃1、cTnI、Ang2水平均显著高于轻伤组,差异均有统计学意义(P<0.05)。Pearson直线相关分析显示:HMGB⁃1、cTnI、Ang2水平与TM、vwF呈正相关(P<0.05)。95例患者死亡19例(20.00%),生存76例(80.00%)。生存组HMGB⁃1、cTnI、Ang2水平明显低于死亡组,差异均有统计学意义(P<0.05)。结论HMGB⁃1、cTnI及Ang2表达水平与急诊多发伤患者血管内皮损伤程度、院内死亡风险相关,三者可作为评估急诊多发伤患者病情进展、预后的重要指标。

Objective To explore the relationship between levels of high⁃mobility group box⁃1(HMGB⁃1),troponin I(CardiacTropnin,cTnI)and angiopoietin⁃2(Ang2),vascular endothelial injury and the risk of hospital death in patients with multiple injuries in the emergency department.Methods 95 patients with multiple injuries in the emergency department admitted to this hospital from January 2017 to December 2020 were selected as the observation group(44 cases in the severe injury group,51 cases in the minor injury group),and 98 healthy people who had physical examination in the hospital during the same period were se⁃lected as the control group.The levels of HMGB⁃1,cTnI,and Ang2 between the groups were compared,and Pearson linear correlation was used to analyze the correlation between the levels of HMGB⁃1,cTnI,and Ang2 and the levels of plasma thrombomodulin(TM)and von Willebrand factor(vwF).The patient's prognosis was observed.Results The levels of HMGB⁃1,cTnI and Ang2 in the observation group were significantly higher than those in the control group,and the differences were both statistically significant(P<0.05).The levels of HMGB⁃1,cTnI and Ang2 in the severe injury group were significantly higher than those in the minor injury group,and the differences were both statistically significant(P<0.05).Pearson linear correlation analy⁃sis showed that the levels of HMGB⁃1,cTnI,and Ang2 were positively correlated with TM and vwF(P<0.05).Among 95 patients,19 died(20.00%)and 76 survived(80.00%).The levels of HMGB⁃1,cTnI and Ang2 in the survival group were significantly lower than those in the death group,and the differences were sta⁃tistically significant(P<0.05).Conclusion The expression levels of HMGB⁃1,cTnI and Ang2 are correlated with the degree of vascular endothelial damage and the risk of hospital death in patients with multiple injuries in emergency department.The three can be used as important indicators to assess the progress and prognosis of patients with multiple injuries in the emergency department.