急性创伤性凝血病患者血清高迁移率族蛋白B1、D-二聚体水平与预后的相关性分析

Correlation between Serum High Mobility Group Protein B1,D-dimer Levels and Prognosis in Patients with Acute Traumatic Coagulopathy

[目的]探讨急性创伤性凝血病(ATC)患者血清高迁移率族蛋白B1(HMGB1)、D-二聚体(D-D)水平与预后的相关性.[方法]选取2019年7月至2020年5月在本院住院治疗的86例ATC患者(观察组),根据ATC患者住院期间预后情况将患者分为生存组和死亡组;另外选取同期在本院体检的74例健康志愿者作为对照组.采用酶联免疫吸附(ELISA)法检测各组血清HMGB1水平;采用免疫比浊法检测各组血清D-D、超敏C反应蛋白(hs-CRP)水平;采用全自动血液凝固仪检测各组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT),采用血液分析仪检测血小板计数(PLT);分析ATC患者HMGB1、D-D水平与凝血功能指标及炎症指标相关性;分析ATC患者预后的影响因素.[结果]观察组HMGB1、D-D、PT、APTT、hs-CRP高于对照组,PLT低于对照组,差异有统计学意义(P<0.05);ATC患者中HMGB1与D-D水平呈正相关(r=0.594,P<0.05),且二者与PT、APTT、hs-CRP呈正相关(P<0.05),与PLT呈负相关(P<0.05).死亡组HMGB1、D-D、PT、APTT、hs-CRP高于生存组,PLT低于生存组,差异有统计学意义(P<0.05);HMGB1、D-D是影响ATC患者死亡的独立危险因素(P<0.05),PLT是影响ATC患者死亡的保护因素(P<0.05).[结论]ATC患者HMGB1、D-D水平升高,对患者预后预测有一定意义.

【Objective】To investigate the correlation between serum high mobility group B1(HMGB1),D-dimer(D-D)levels and prognosis in patients with acute traumatic coagulopathy(ATC).【Methods】A total of 86 ATC patients(observation group)hospitalized in our hospital from July 2019 to May 2020 were selected and divided into survival group and death group according to the prognosis of ATC patients during hospitalization;In addition,74 healthy volunteers who were examined in our hospital at the same time were selected as the control group.The serum HMGB1 level was detected by ELISA;Serum D-D and hs-CRP levels were detected by immunoturbidimetry;Prothrombin time(PT),activated partial thromboplastin time(APTT)and platelet count(PLT)were measured by automatic blood coagulation analyzer;The correlation between the levels of HMGB1 and D-D and the indexes of coagulation function and inflammation in patients with ATC was analyzed;The prognostic factors of ATC patients were also analyzed.【Results】HMGB1,D-D,PT,APTT,hs-CRP in the observation group were higher than those in the control group,while PLT was lower than that in the control group,with statistical significance(P<0.05);HMGB1 was positively correlated with D-D levels in ATC patients(r=0.594,P<0.05),and positively correlated with PT,APTT,hs-CRP(P<0.05),and negatively correlated with PLT(P<0.05).HMGB1,D-D,PT,APTT,hs-CRP in the death group were higher than those in the survival group,while PLT was lower than those in the survival group,with significant difference(P<0.05);HMGB1 and D-D were independent risk factors for death of ATC patients(P<0.05),and PLT was protective factor for death of ATC patients(P<0.05).【Conclusion】The levels of HMGB1 and D-D in patients with ATC are elevated,which has certain significance in predicting the prognosis of patients.