血清HMGB-1、sRAGE水平与基底节脑出血患者神经功能缺损及预后的关系

Relationship between serum HMGB-1, sRAGE levels and neurological deficits and prognosis in patients with basal ganglia intracerebral hemorrhage

目的 探讨血清高迁移率族蛋白-1(HMGB-1)、可溶性晚期糖基化终产物受体(sRAGE)水平在基底节脑出血患者中的表达及其与患者神经功能缺损及预后的关系。方法 回顾性选取2019年3月至2021年3月在河北中医学院第二附属医院诊治的基底节脑出血患者138例(病例组),另选取同期因头痛等原因进行常规体检者126例(对照组)。收集两组一般资料并进行对比。采用酶联免疫吸附试验测定血清HMGB-1、sRAGE水平;采用中国脑卒中患者临床神经功能缺损程度评分量表(CSS)评估患者的神经功能缺损情况,将其分为轻型55例、中型43例、重型40例;利用改良Rankin量表(mRS)对患者评分,根据评分将随访患者分为预后良好组和预后不良组;采用Pearson法分析血清HMGB-1与sRAGE水平的相关性;Logistic回归分析基底节脑出血患者预后不良的影响因素。结果 病例组血清HMGB-1、sRAGE水平分别为(6.48±1.25) mg/L、(1.64±0.35) ng/mL,均显著高于对照组[(1.05±0.25) mg/L、(0.89±0.18) ng/mL],差异均有统计学意义(P<0.05)。重型基底节脑出血患者血清HMGB-1、sRAGE水平最高,其次为中型,最后为轻型患者。预后良好组81例,预后不良组57例,预后不良组患者血清HMGB-1、sRAGE水平分别为(7.98±1.31) mg/L、(2.12±0.41) ng/mL,均显著高于预后良好组[(5.42±1.25) mg/L、(1.31±0.31) ng/mL],差异均有统计学意义(P<0.05)。病例组血清HMGB-1与sRAGE水平呈显著正相关(r=0.667,P<0.001)。Logistic回归分析显示,高血压、HMGB-1、sRAGE均为基底节脑出血患者不良预后的独立影响因素(P<0.05)。结论 HMGB-1、sRAGE在基底节脑出血患者血清中高表达,二者参与基底节脑出血的发生、发展,二者表达水平的高低与患者神经功能缺损及预后有关,有望成为基底节脑出血患者预后评估的生物标志物。

Objective To investigate the expression of serum high mobility group box-1(HMGB-1)and soluble receptor of advanced glycation end product(sRAGE)in patients with basal ganglia intracerebral hemorrhage and their relationship with neurological function deficits and prognosis.Methods From March 2019 to March 2021,138 patients(case group)with basal ganglia intracerebral hemorrhage diagnosed and treated in the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine were retrospectively selected,in addition,126 people(control group)who received routine physical examination due to headache and other reasons were selected.And the general data of the two groups were collected and compared.The levels of serum HMGB-1 and sRAGE were measured by enzyme-linked immunosorbent assay(ELISA);the Chinese stroke scale of clinical neurologic deficit grade(CSS)was used to assess the neurological deficit of the patients,and the patients were grouped into 55 cases of mild,43 cases of medium,and 40 cases of severe;the patients were scored with the modified Rankin Scale(mRS)and divided into good prognosis group and poor prognosis group;Pearson method was applied to analyze the correlation between serum HMGB-1 and sRAGE levels;Logistic regression analysis was applied to analyze the influencing factors of poor prognosis in patients with basal ganglia intracerebral hemorrhage.Results The serum levels of HMGB-1 and sRAGE in the case group were(6.48±1.25)mg/L and(1.64±0.35)ng/mL,respectively,which were significantly higher than those in the control group[(1.05±0.25)mg/L and(0.89±0.18)ng/mL],the differences were statistically significant(P<0.05).The levels of serum HMGB-1 and sRAGE were the highest in patients with severe basal ganglia intracerebral hemorrhage,followed by medium and mild patients;there were 81 cases in the good prognosis group and 57 cases in the poor prognosis group,the levels of serum HMGB-1 and sRAGE in the poor prognosis group were(7.98±1.31)mg/L,(2.12±0.41)ng/mL,retrospectively,which were significantly higher than those in the good prognosis group[(5.42±1.25)mg/L,(1.31±0.31)ng/mL],the differences were statistically significant(P<0.05).There was a obvious positive correlation between serum HMGB-1 and sRAGE levels(r=0.667,P<0.001).Logistic regression analysis showed that hypertension,HMGB-1 and sRAGE were independent influencing factors of poor prognosis in patients with basal ganglia intracerebral hemorrhage(P<0.05).Conclusion HMGB-1 and sRAGE are highly expressed in the serum of patients with basal ganglia intracerebral hemorrhage,both are involved in the occurrence and development of basal ganglia intracerebral hemorrhage,their expression levels are related to the neurological function deficits and prognosis of patients,and may be biomarkers for prognosis evaluation of patients with basal ganglia intracerebral hemorrhage.