【摘要】：目的觀察重癥肺炎患者血清及肺泡灌洗液中高遷移率族蛋白B1(HMGBl)的水平及變化趨勢(shì),探討其與重癥肺炎患者病情嚴(yán)重程度的關(guān)系。方法選擇2010年12月-2011年6月行機(jī)械通氣的42例重癥肺炎患者,將其預(yù)后分為存活組及死亡組;以同期14名健康體檢者為陰性對(duì)照組,檢測(cè)重癥肺炎患者在入住重癥醫(yī)學(xué)科的第1、3、7天及轉(zhuǎn)出ICU(或死亡)當(dāng)天的血清及肺泡灌洗液中HMGBl、PCT水平及行APACHEⅡ評(píng)分;健康體檢者體檢時(shí)的血清HMGB1、PCT水平;根據(jù)原始數(shù)據(jù)錄入SPSS13.0統(tǒng)計(jì)軟件,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果入住重癥醫(yī)學(xué)科第1天重癥肺炎組血清HMGB1(172.10±15.32)μg/L高于對(duì)照組的(4.73±1.49)μg/L(P0.05);第3、7天及轉(zhuǎn)科(死亡)當(dāng)天,死亡組的血清和肺泡灌洗液HMGB1濃度分別為(202.41±20.98)、(218.86±25.42)、(225.37±24.30)μg/L及(8.79±1.91)、(10.87±1.31)、(12.08±1.85)μg/L,均高于存活組(P0.05);血清及肺泡灌洗液HMGB1水平存活組逐漸下降,死亡組逐漸上升;血清和肺泡灌洗液HMGB1水平與APACHEⅡ評(píng)分呈直線相關(guān)(r=0.334,P=0.009和r=0.298,P=0.031);血清與肺泡灌洗液HMGB1水平呈正相關(guān)(r=0.339,P=0.014)。結(jié)論基礎(chǔ)APACHEⅡ評(píng)分越高預(yù)后越差,HMGB1水平能反映炎癥及組織損傷的輕重程度,能協(xié)助評(píng)價(jià)病情、判斷預(yù)后;重癥肺炎患者局部及全身炎癥反應(yīng)存在有一定的關(guān)聯(lián)性。
[Abstract]:Objective to observe the level and trend of high mobility group protein B1 (HMGBl) in serum and alveolar lavage fluid of patients with severe pneumonia, and to explore its relationship with the severity of severe pneumonia. Methods 42 patients with severe pneumonia who underwent mechanical ventilation from December 2010 to June 2011 were divided into survival group and death group. The serum and alveolar lavage fluid (HMGBl,PCT) levels and APACHE 鈪，

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