Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surg Today. 2011 Jul;41(7):903-7. doi: 10.1007/s00595-010-4371-4. Epub 2011 Jul 12.
High-mobility group box 1 (HMGB-1) is a late-phase cytokine, which is released extracellularly in response to systemic inflammation caused by infection, shock, or trauma. We examined the plasma levels of HMGB-1 to clarify its role in surgical stress.
The subjects of this study were 37 patients who underwent elective general surgery. We measured plasma concentrations of HMGB-1 over time using a quantitative enzyme-linked immunosorbent assay. We then analyzed the relationships between the change in HMGB-1 concentration and perioperative factors, including postoperative complications. Statistical analyses were performed using two-way repeated-measures analysis of variance.
The HMGB-1 level was higher on postoperative day 3 in patients with a prolonged operative time or large intraoperative blood loss (P = 0.048 and P = 0.041, respectively). The HMGB-1 level also remained high over time in patients with postoperative complications (P = 0.037).
These results show that the plasma HMGB-1 level is related to surgical stress such as operative time and blood loss. The level remained high over time in patients with postoperative complication, suggesting progression of the complication.
高迁移率族蛋白 B1（HMGB-1）是一种晚期细胞因子，在感染、休克或创伤引起的全身炎症反应时被释放到细胞外。我们检测了 HMGB-1 的血浆水平，以阐明其在手术应激中的作用。
本研究的对象是 37 例行择期普外科手术的患者。我们使用定量酶联免疫吸附试验（ELISA）检测 HMGB-1 浓度随时间的变化。然后，我们分析了 HMGB-1 浓度变化与包括术后并发症在内的围手术期因素之间的关系。采用双因素重复测量方差分析进行统计学分析。
手术时间延长或术中出血量较大的患者在术后第 3 天 HMGB-1 水平更高（P = 0.048 和 P = 0.041）。有术后并发症的患者 HMGB-1 水平也随时间持续升高（P = 0.037）。
这些结果表明，血浆 HMGB-1 水平与手术应激有关，如手术时间和出血量。有术后并发症的患者 HMGB-1 水平随时间持续升高，提示并发症进展。
