病毒性脑炎患者血清HMGB1表达水平与疾病严重程度及预后的关系

Relationship between serum HMGB1 expression level with disease severity and prognosis in patients with viral encephalitis

目的 探究病毒性脑炎(VE)患者血清高迁移率基团蛋白B1(HMGB1)表达水平与疾病严重程度及预后的关系。方法 选取83例在本院2020年9月~2023年9月收治的VE患者作为疾病组,根据病情严重程度,分为轻症组(n=57)、重症组(n=26);依据格拉斯哥预后评分量表(GOS)评分评估预后,分为预后良好组(n=52)、预后不良组(n=31);另选取同期健康体检者83例作为对照组。ELISA法检测血清HMGB1、神经元特异性烯醇化(NSE)表达水平,并进行组间比较;多因素Logistic回归分析VE患者预后的影响因素;ROC曲线分析血清HMGB1、NSE对预后的评估价值。结果 疾病组血清HMGB1、NSE表达水平明显高于对照组(P<0.05),VE患者血清HMGB1与NSE水平呈正相关性(r=0.502,P=0.000);重症组血清HMGB1、NSE表达水平均显著高于轻症组(P<0.05);预后不良组白细胞计数、血清HMGB1、NSE水平均显著高于预后良好组(P<0.05);白细胞计数、血清HMGB1、NSE为影响VE患者预后的相关因素(P<0.05);血清HMGB1、NSE及二者联合评估VE患者预后的曲线下面积(AUC)分别为0.768、0.818、0.892,优于血清HMGB1、NSE各自单独检测(Z二者联合-HMGB1=2.989、Z二者联合-NSE=2.179,P=0.003、0.029),其敏感度和特异度分别为70.97%、98.08%。结论 VE患者血清HMGB1水平明显升高,与病情严重程度及预后密切相关,对VE患者预后有较高的评估价值。

Objective To explore the relationship between the expression level of serum high mobility group protein B1(HMGB1)with the severity and prognosis of viral encephalitis(VE)patients.MethodsFrom September 2020 to September 2023,83 VE patients admitted to our hospital were regarded as the disease group.According to the severity of disease,they were separated into mild group(n=57)and severe group(n=26).According to the Glasgow Outcome Scale(GOS),the prognosis was evaluated and they were separated into a good prognosis group(n=52)and a poor prognosis group(n=31).Meantime,83 healthy individuals who underwent physical examinations were included as the control group.ELISA method was applied to detect the expression levels of serum HMGBl and neuron specific enolization(NSE),and intergroup comparison was performed.Multivariate logistic regression was applied to analyze the factors influencing the prognosis of VE patients.ROC curve was applied to analyze the prognostic evaluation value of serum HMGB1 and NSE.ResultsThe expression levels of serum HMGBl and NSE in the disease group were obviously higher than those in the control group(P<0.05),and there was a positive correlation between serum HMGB1 and NSE levels in VE patients(r=0.502,P=0.000).The expression levels of serum HMGB1 and NSE in the severe group were obviously higher than those in the mild group(P<0.05).The white blood cell count,serum HMGBl,and NSE levels in the poor prognosis group were obviously higher than those in the good prognosis group(P<0.05).White blood cell count,serum HMGBl,and NSE were related factors affecting the prognosis of VE patients(P<0.05).The area under the curve(AUC)of serum HMGBI,NSE,and their combined evaluation for the prognosis of VE patients was 0.768,0.818,and 0.892,respectively,the combined evaluation was superior to the individual detection of serum HMGB1 and NSE(Zombmaion-HMGBI=2.989,Zoombintion-NsE=2.179,P=0.003,0.029),and its sensitivity and specificity were 70.97%and 98.08%,respectively.Conclusion The serum HMGB1 level in VE patients is obviously elevated,it is closely related to the severity and prognosis of disease, and has high evaluation value for the prognosis of V E patients.