急性阑尾炎时血清高迁移率蛋白-1含量变化的意义(1)
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【摘要】 目的 探讨血清高迁移率蛋白 1(HMGB1)和高敏C反应蛋白(Hs CRP)的含量变化在急性阑尾炎诊断中的价值。方法 采用酶联免疫吸附法(ELISA)检测血清HMGB1含量,同时采用免疫比浊法对血清Hs CRP进行测定;将三组阑尾炎患者(急性坏疽性阑尾炎35例,急性化脓性阑尾炎48例,急性单纯性阑尾炎32例)和阑尾无炎症患者(30例)HMGB1和Hs CRP水平进行比较。结果 三组急性阑尾炎患者与阑尾无炎症患者比较,HMGB1和Hs CRP水平均较阑尾无炎症患者明显升高(P<0.01);急性坏疽性阑尾炎及急性化脓性阑尾炎与急性单纯性阑尾炎比较,HMGB1和Hs CRP水平明显升高(P<0.01)。同时急性阑尾炎患者HMGB1浓度与Hs CRP浓度呈正相关(r=0.62,P<0.01)。结论 在临床症状及白细胞计数升高的基础上,结合血清HMGB1和Hs CRP的测定对急性阑尾炎的诊断具有一定价值。
【关键词】阑尾炎;高迁移率蛋白 1; 高敏C反应蛋白
The value of HMGB1 in the diagnosis of acute appendicitis
ZHANG Guo feng,ZHOU Yong qin,ZHANG Guo,et al.
Depantment of General surgery,The Central People’s Hospital of Tengzhou,Shandong 277500,China
【Abstract】 Objective To analyze the value of high mobility groupbox 1(HMGB1)and high sensitive C reactive Protein(Hs CRP)in the diagnosis of acute appendicitis.Methods The HMGB1 in serum of no inflammation cases and three groups of acute appendicitis was examined respectively.Concentrations of HMGB1 was determined by enzyme linked immunosorbent assay(ELISA),and Hs CRP was determined by rate nephelometry immunoassay.Results The serum HMGB1 and Hs CRP level in three groups of acute appendicitis was much higher than that in the no inflammation cases with a significant difference(P<0.01); The serum HMGB1 and Hs CRP level in patients with suppurative and gangrenous appendicitis were much higher than that in patients with simple appendicitis(P<0.01).There was positive correlation between the concentrations of HMGB1 and hs CRP(r=0.62,P<0.01).Conclusion The serum HMGB1 and Hs CRP test are valuable in diagnosis of acute appendicitis on the basis of the clinical symptom and WBC levels.
【Key words】Appendicitis; High mobility groupbox 1(HMGB1); High sensitive C reactive Protein(Hs CRP)
急性阑尾炎的诊断是临床外科一个常见的问题。即使仔细地进行临床、实验室及超声等检查,切除无病阑尾和阑尾穿孔者仍占全部临床诊断为急性阑尾炎而行阑尾切除患者的20%左右。高迁移率族蛋白 1(HMGB1)是近年发现的一种重要的晚期炎症介质,在炎症反应过程中表达升高较晚,维持时间较长,与组织损伤后修复、炎症反应等关系密切[1]。本研究通过检测急性阑尾炎患者血清HMGB1和高敏C 反应蛋白(Hs CRP)的含量变化,探讨其对急性阑尾炎的诊断价值。
1 资料与方法
1.1 临床资料 选取2008年3月至2009年12月在我院进行切除术的急性阑尾炎和误诊为急性阑尾炎患者145例,年龄(25.14±2.35)岁。根据切除阑尾的病理诊断结果进行分组,急性坏疽性阑尾炎组35例,急性化脓性阑尾炎组48例,急性单纯性阑尾炎组32例,阑尾无炎症组30例 ......
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