脑出血患者血浆高迁移率族蛋白B1浓度的检测及临床意义

目的:揭示脑出血患者血浆高迁移率族蛋白B1浓度的变化,探讨其对预后的预测价值。方法:收集高血压性基底节区出血患者作为脑出血组,共98例。收集同期健康体检人群作为对照组,共40例。脑出血组静脉血在入院时获得。对照组静脉血体检时获得。ELISA检测血浆高迁移率族蛋白B1浓度。统计分析其与患者预后的相关性。结果:脑出血后1个月内死亡29例(29.6%)。t检验显示,脑出血组血浆高迁移率族蛋白B1浓度(7.6±2.7)ng/ml显著高于对照组(1.3±0.4)ng/ml(P<0.001)。多因素分析显示,血浆高迁移率族蛋白B1浓度与脑出血患者入院时GCS评分呈显著负相关(P<0.001),是脑出血1个月内死亡的独立危险因素(OR=1.384,95%CI=1.114～1.551,P<0.01)。ROC曲线分析显示,血浆高迁移率族蛋白B1浓度预测脑出血1个月内死亡有显著预测价值(曲线下面积=0.823,95%CI=0.759～0.892,P<0.001),且判定血浆高迁移率族蛋白B1浓度7.9ng/ml,对预测脑出血1个月内死亡有86.2%的灵敏度和79.7%的特异度。结论:脑出血后血浆高迁移率族蛋白B1浓度升高,临床检测这个指标有助于早期判断脑出血患者的预后。

Determination of Plasma High Mobility Group Box 1 Protein Concentration in Patients with Hypertensive Intracerebral Hemorrhage and its Clinical Significance

Objective To study the change of plasma high mobility group box 1 protein level was determined in patients with hypertensive intracerebral hemorrhage and its correlation with outcome was evaluated. Methods 98 consecutive patients with spontaneous basal ganglia hemorrhage. Besides, 40 age- and sex-matched healthy controls were enrolled into this study. Plasma samples were obtained on entry in healthy controls, as well as on admission in the patients. Its concentration was measured by enzyme-linked immunosorbent assay. Results 29 patients （29.6%） died from intracerebral hemorrhage in a month. The plasma high mobility group box 1 protein level （7.6 ±2.7ng/ml） in patients was significantly higher than that （ 1.3± 0.4 ng/ml） in healthy controls using t test （ t = 8. 371, P 〈0.001 ）. A multivariate linear regression selected GCS score （ P 〈0.001 ） related to plasma high mobility group box 1 protein level. On a multivariate logistic regression, plasma high mobility group box 1 protein level （ odds ratio = 1. 384, 95 % C. I. = 1.114 -1. 551, P 〈0.01 ） was an independent variable predicting 1-month mortality. A receiver operating characteristic curve identified that a plasma high mobility group box 1 protein level 〉7.9 ng/ml predicted 1-month mortality of patients with 86.2% sensitivity and 79.7% specificity （ Area under curve = 0.823, 95 % CI = 0.759 - 0. 892, P 〈 0.001 ）. Conclusion Increased high mobility group box 1 protein level is found after intracerebral hemorrhage in association with a poor clinical outcome. Such a laboratory marker maybe helpful to judge the prognosis of these patients at early stage.