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目的探讨实施心肺复苏(CPR)后血液中高迁移率族蛋白B1(HMGB1)的表达水平与病人预后的关系。方法收集心脏骤停后实施CPR患者90例,根据CPR救治结果分组:P1组(CPR 30 min无效死亡)30例;P2组(复苏成功,自主循环建立≥2 h,但最终出现死亡)30例;H组(复苏成功,预后较好)30例。同时选择暨南大学第一附属医院体检健康者30例为C组。采用酶链免疫吸附法(ELISA)检测患者血清白细胞介素(IL)-1β,IL-4,IL-10和肿瘤坏死因子-α(TNF-α)的含量。采用Western-bolt方法,检测患者血液样本中HMGB1蛋白相对表达量。结果 IL-1β、TNF-α、IL-4、IL-10四组间差异具有统计学意义(P均<0.05),其中H组、P1组、P2组IL-1β、TNF-α、IL-4、IL-10水平均高于C组,P1组和P2组高于H组,差异均具有统计学意义(P均<0.05),说明随着患者预后不良程度的增加,血清的炎性因子的水平逐渐增加。C组、H组、P2组、P1组HMGB1蛋白相对表达量分别为101.23±14.67、175.45±8.89、213.23±10.12、298.48±11.48,各组差异具有统计学意义(F=23.561,P=0.000),其中C组、H组、P2组HMGB1蛋白水平均低于P1组,C组和H组低于P2组,C组低于H组,差异均具有统计学意义(P均<0.05),说明随着进行CPR病人预后的不良程度的增加,HMGB1的表达逐渐升高。结论患者经过CPR后,外周血中促炎/抗炎因子的释放与病人的预后密切相关。
Objective To investigate the relationship between the expression of high mobility group box 1 (HMGB1) and the prognosis of patients after cardiopulmonary resuscitation (CPR). Methods Ninety patients with CPR after cardiac arrest were enrolled. According to the results of CPR treatment, 30 patients in group P1 (30 died after CPR failure) and 30 patients in group P2 (successful resuscitation and> 2 h in spontaneous circulation) ; H group (successful recovery, good prognosis) 30 cases. At the same time choose the first affiliated hospital of Jinan University 30 cases of physical examination for the C group. Serum levels of IL-1β, IL-4, IL-10 and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA) Western-bolt method was used to detect the relative expression of HMGB1 in the blood samples of patients. Results The IL-1β, TNF-α, IL-4 and IL-10 levels were significantly different between the four groups (P <0.05) 4, IL-10 levels were higher than C group, P1 group and P2 group higher than H group, the difference was statistically significant (P all <0.05), indicating that with the poor prognosis of patients increased serum inflammatory cytokines Gradually increase the level of. The relative expression levels of HMGB1 protein in group C, group H, group P2 and group P1 were 101.23 ± 14.67,175.45 ± 8.89, 213.23 ± 10.12 and 298.48 ± 11.48 respectively, with statistical significance (F = 23.561, P = 0.000) . The protein levels of HMGB1 in group C, group H and group P2 were lower than group P1, group C and group H were lower than group P2, group C was lower than group H, the difference was statistically significant (P <0.05) The HMGB1 expression gradually increased with the increase of the degree of adverse prognosis in CPR patients. Conclusions The release of proinflammatory / anti-inflammatory cytokines in peripheral blood is closely related to the prognosis of patients after CPR.