血HMGB1在急性肾损伤中的临床意义

The Clinical Significance of Serum HMGB1 in Acute Kidney Injury

目的:探索血高迁移率族蛋白1(high mobility group protein B1,HMGB1)在急性肾损伤(acute kidney injury,AKI)疾病进程中的临床意义。方法:分别收集40例AKI患者及30例AKI高危人群的临床资料,并采集其血标本,同时选取10例同期健康体检者为对照组。检测AKI患者血HMGB1、胱抑素C(cystatin C,Cys C)、肌酐(creatinine,Cr)水平,并与对照组进行比较分析;检测AKI患者各分期、行连续性血液净化治疗(continuous renal replacement therapy,CRRT)治疗前与肾功恢复正常后血HMGB1、Cys C、Cr水平并行比较分析。分别检测30例AKI高危人群入院后0 h、6 h、12 h、24 h、48 h的血HMGB1水平,并与同时段血Cys C、Cr水平进行比较分析。结果:(1)在AKI患者组,血HMGB1水平明显高于对照组,且血HMGB1水平与AKI患者肾脏损伤程度呈正相关性;肾功能恢复正常后,血HMGB1水平下降,差异均有统计学意义(P <0. 05)。(2)在AKI高危人群组,血HMGB1水平明显高于正常人群,且进展至AKI者血HMGB1水平明显高于未进展至AKI者。(3)在AKI高危人群组,出现急性肾损伤前,血HMGB1较Cys C、Cr更早升高,差异有统计学意义(P <0. 05)。结论:血HMGB1水平在肾脏损伤早期即有变化,且与肾脏损伤程度呈正相关性,可望作为AKI早期诊断和评估预后的临床指标。

Objective:To investigate the clinical significance of serum HMGB1 in the?progress?of Acute Kidney Injury(AKI).Methods:The clinical data and blood samples of 40 AKI patients and 30 AKI high-risk groups were collected.At the same time,10 healthy people were selected as the control group.Serum High Mobility Group protein B1(HMGB1),Cystatin C(Cys C),Creatinine(Cr)were measured in AKI patients,and compared to the control group;The levels of serum HMGB1,Cys C,Cr were measured and analyzed in patients with each stage of AKI,before receiving continuous renal replacement therapy(CRRT)and after their renal function recovered via CRRT.The monitoring data of serum HMGB1 from 30 patients who were at high risk of developing AKI at 0 h,6 h,12 h,24 h,48 h after admission,and compared with the level of Cys C,Cr.Results:The serum HMGB1 level were significantly higher in AKI patients group compared to the control group,and the increasing of serum HMGB1 in AKI group was positively correlated with the severity of kidney injury.The serum HMGB1 level were decreased after the remission of renal function via CRRT(p<0.05).In the patients with the high-risk of AKI,serum HMGB1 was significantly increased compared to the control group,and the levels of serum HMGB1 in the patients who were progressed to AKI were significantly higher than that of patients without AKI.Serum HMGB1 was raised in the early stage of kidney injury,and significantly earlier than CYs C and Cr(p<0.05).Conclusion:Serum HMGB1 was involved in the progress of AKI,and positively related to kidney injury,which may be a potential biomarker for early diagnosis and assessing prognosis of AKI.