Gibot Sébastien, Massin Frédéric, Cravoisy Aurélie, Barraud Damien, Nace Lionel, Levy Brune, Bollaert Pierre-Edouard
Hôpital Central, Service de Réanimation Médicale, 29 avenue du Maréchal de Lattre de Tassigny, 54000, Nancy, France.
Intensive Care Med. 2007 Aug;33(8):1347-53. doi: 10.1007/s00134-007-0691-2. Epub 2007 May 25.
To investigate plasma high-mobility group box 1 protein (HMGB1) concentration and its relationship with organ dysfunction and outcome in septic shock patients.
Prospective, noninterventional study. Medical adult intensive care unit at a university hospital in France.
42 critically ill patients with septic shock.
Arterial blood was drawn within 12 h of admission for the measurement of plasma HMGB1 concentration by ELISA. Repeated sampling was performed on days 3, 7, and 14.
Median HMGB1 concentration was 4.4 ng/ml (IQR 1.2-12.5) at admission, with no difference between survivors and nonsurvivors. A positive correlation was observed between HMGB1 and SOFA score and lactate, and procalcitonin concentrations. There was a progressive but statistically nonsignificant decline in HMGB1 concentration among the survivors, while nonsurvivors showed an increase in HMGB1 level between days 1 and 3. SOFA score and lactate and procalcitonin concentrations did not vary significantly between days 1 and 3. When measured on day 3, HMGB1 discriminated survivors from nonsurvivors with 66% sensitivity and 67% specificity, and concentration greater than 4 ng/ml was associated with an odds ratio of death of 5.5 (95% CI 1.3-23.6).
探讨脓毒性休克患者血浆高迁移率族蛋白B1（HMGB1）浓度及其与器官功能障碍和预后的关系。
前瞻性、非干预性研究。法国一家大学医院的内科成人重症监护病房。
42例脓毒性休克重症患者。
入院后12小时内采集动脉血，采用酶联免疫吸附测定法（ELISA）检测血浆HMGB1浓度。在第3、7和14天进行重复采样。
入院时HMGB1浓度中位数为4.4 ng/ml（四分位间距1.2 - 12.5），存活者与非存活者之间无差异。观察到HMGB1与序贯器官衰竭评估（SOFA）评分、乳酸及降钙素原浓度呈正相关。存活者中HMGB1浓度呈逐渐下降趋势，但无统计学意义，而非存活者在第1天至第3天HMGB1水平升高。第1天至第3天SOFA评分、乳酸及降钙素原浓度无显著变化。在第3天测量时，HMGB1区分存活者与非存活者的敏感度为66%，特异度为67%，浓度大于4 ng/ml时死亡比值比为5.5（95%可信区间1.3 - 23.6）。
