高迁移率族蛋白1在蛛网膜下腔出血脑血管痉挛病人外周血中的表达及临床意义

Expression of Peripheral Blood HMGB-1 in Patients with Cerebral Vasospasm under Subarachnoid Hemorrhage and Its Clinical Significance

目的观察高迁移率族蛋白-1(HMGB-1)在自发性蛛网膜下腔出血(SAH)脑血管痉挛(CVS)病人脑脊液中的表达情况,并初步探讨其临床意义。方法收集我科2014年1月—2017年6月收治的蛛网膜下腔出血病人65例,根据其随后是否发生脑血管痉挛分为CVS组(20例)及Non-CVS组(45例),通过ELISA法动态监测两组病人术后1 d～10 d脑脊液中HMGB-1的表达变化,并分析其与病人Hunt-Hess分级及Fisher分级的关系。结果与CVS组比较,Non-CVS组病人血清中HMGB-1表达水平明显升高,且随着损伤程度加重而进一步升高(P <0.05);同时动态检测结果显示HMGB-1在伤后6 d～8 d达到峰值,随后逐渐下降;HMGB-1的表达与病人Hunt-Hess分级及Fisher分级密切相关。结论 HMGB-1在蛛网膜下腔出血脑血管痉挛病人外周血中的表达明显升高,可能对其诊断和治疗具有重要的临床意义。

Objective To observe the expression of high-mobility group box 1(HMGB-1)in cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage(sSAH)cerebral vasospasm(CVS),and to explore its clinical significance.Methods Sixty-five patients with subarachnoid hemorrhage admitted in our department from January 2014 to June 2017 were divided into CVS group(n=20)and non-CVS group(n=45)according to their subsequent cerebral vasospasm.The expression of HMGB1 in the cerebrospinal fluid was measured by ELISA.The relationship between the expression of HMGB1 and the classification of Hunt-Hess and Fisher was analyzed.Results Compared with CVS group,the level of serum HMGB1 in patients with Non-CVS was significantly higher than that in CVS group(P<0.05).Meanwhile,the results of dynamic test showed HMGB-1 reached peak at 6-8 days after injury peak,and then gradually decreased.HMGB-1 expression was closely related to Hunt-Hess grading and Fisher classification in patients.Conclusion HMGB-1 expression in peripheral blood of patients with sSAH cerebral vasospasm was significantly higher,which may have important clinical significance for its diagnosis and treatment.