AP患者血清HMGB1和NO对病情评估价值及相关性研究

Value of serum HMGB1 and NO for evaluating the condition of AP patients and their correlation

目的探讨急性胰腺炎(acute pancreatitis,AP)患者血清高迁移率族蛋白B1(high mobility group protein B1,HMGB1)和一氧化氮(nitric oxide,NO)的表达对AP患病及严重程度的评估价值,并分析两者的相关性。方法收集AP病例70例,其中轻症急性胰腺炎(mild acute pancreatitis,MAP)组27例,中度重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)组21例,重症急性胰腺炎(severe acute pancreatitis,SAP)组22例,以32例同期健康体检者作为对照组。采用ELISA检测各组血清HMGB1表达水平,分光光度法检测NO表达水平,通过ROC曲线探究HMGB1和NO对评估AP严重程度及患病的敏感性及特异性,并分析各组HMGB1水平与NO浓度之间的相关性。结果各组的一般资料比较,差异无统计学意义(P>0.05)。MAP组、MSAP组、SAP组患者血清中HMGB1、NO水平均显著高于对照组(P<0.01);MSAP组的NO水平高于MAP组(P<0.001),而HMGB1水平差异无统计学意义(P>0.05);SAP组的HMGB1、NO水平高于MAP及MSAP组(P<0.05)。SAP组中HMGB1与NO水平呈正相关(r s=0.672,P<0.001)。AP严重程度越高,HMGB1和NO水平越高,对评估AP严重程度及患病的敏感性及特异性增加。结论血清HMGB1及NO的表达水平对判断AP患病及严重程度有一定的评估价值;在SAP中,HMGB1和NO的表达水平具有相关性,其可能通过促进NO产生增多,共同参与SAP的发生发展。

Objective To investigate the evaluation value of the expression of high mobility group protein B1(HMGB1)and nitric oxide(NO)in serum on the incidence and severity of acute pancreatitis(AP),and to analyze the correlation between HMGB1 expression and NO expression.Methods 70 cases of AP were selected,including 27 cases of mild acute pancreatitis(MAP group),21 cases of moderate severe acute pancreatitis(MSAP group),22 cases of severe acute pancreatitis(SAP group).32 healthy subjects in the same period were selected as control group.The expression of serum HMGB1 in each group was detected by ELISA,and the expression of NO detected by spectrophotometry.The sensitivity and specificity of HMGB1 and NO in evaluating the severity and incidence of AP was explored by ROC curve.Correlation between HMGB1 level and NO concentration was also anayzed in each group.Results There was no significant difference in the general data among all groups(P>0.05).The MAP group,MSAP group and SAP group all had significantly higher levels of HMGB1 and NO than the control group(P<0.01).The level of NO in the MSAP group was higher than that in the MAP group(P<0.001),but No significant difference was found in HMGB1 level between two groups(P>0.05).The levels of HMGB1 and NO in the SAP group were higher than those in the MAP and MSAP groups(P<0.05).There was a positive correlation between HMGB1 level and NO level in the SAP group(r s=0.672,P<0.001).The higher the severity of AP,the higher the level of HMGB1 and NO,and there would be an increase in the sensitivity and specificity of assessing the severity and incidence of AP.Conclusion The expressions of serum HMGB1 and NO have a certain value in evaluating the severity and incidence of AP.In SAP,the expression of HMGB1 is correlated with the expression of NO.They may jointly participate in the occurrence and development of SAP by promoting the increase of NO production.