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脓毒症和弥散性血管内凝血中高迁移率族蛋白B1水平

High mobility group B1 levels in sepsis and Disseminated Intravascular Coagulation.

作者信息

Eskici Zeynep M, Açıkgöz Şerefden, Pişkin Nihal, Mungan Görkem, Can Murat, Güven Berrak, Köktürk Fürüzan

机构信息

Department of Biochemistry, Zonguldak Karaelmas University, Faculty of Medicine, Esenköy-Kozlu-Zonguldak, Turkey.

出版信息

Acta Biochim Pol. 2012;59(4):561-6. Epub 2012 Oct 23.

Abstract

Cytokines trigger coagulant and fibrinolytic systems in sepsis to result in Disseminated Intravascular Coagulation (DIC) that is an important complication and leads to disseminated hemorrhages and multi-organ failure. High Mobility Group B1 DNA Binding (HMGB1) protein is a cytokine taking part in systemic inflammatory response. The objective of this study was to investigate HMGB1 levels in groups of septic patients with and without DIC.Twenty-one septic patients without DIC and 12 septic patients with DIC from the Intensive Care Unit (ICU) were included in the study. In addition, 20 patients admitted to the ICU without sepsis or DIC and 20 healthy volunteers served as controls. Levels of HMGB1, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, protein C, protein S, anti-thrombin III (ATIII), platelet (thrombocyte) and leukocyte count were determined. Levels of fibrinogen, protein C, ATIII and platelet count were significantly lower and D-dimer was significantly higher in the group with sepsis plus DIC compared to the group with sepsis without DIC. Levels of HMGB1 were higher in the group with sepsis and DIC compared to the group with sepsis; however, the difference was not statistically significant and the levels of HGMB1 of both groups were significantly higher compared to ICU and healthy control groups. HMGB1 levels were not significantly different in survivor and non survivor patients. HMGB1 levels did not differ in lower respiratory tract infection (LRTI) and urinary tract infection (UTI) in regard to the etiology of sepsis.

摘要

细胞因子在脓毒症中触发凝血和纤维蛋白溶解系统,导致弥散性血管内凝血(DIC),这是一种重要的并发症,可导致弥散性出血和多器官功能衰竭。高迁移率族蛋白B1(HMGB1)是一种参与全身炎症反应的细胞因子。本研究的目的是调查伴有和不伴有DIC的脓毒症患者组中HMGB1的水平。本研究纳入了重症监护病房(ICU)的21例无DIC的脓毒症患者和12例有DIC的脓毒症患者。此外,20例入住ICU但无脓毒症或DIC的患者以及20名健康志愿者作为对照。测定了HMGB1、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、D-二聚体、蛋白C、蛋白S、抗凝血酶III(ATIII)、血小板(血栓细胞)和白细胞计数。与无DIC的脓毒症组相比,伴有脓毒症加DIC组的纤维蛋白原、蛋白C、ATIII水平和血小板计数显著降低,D-二聚体显著升高。与脓毒症组相比,伴有脓毒症和DIC组的HMGB1水平更高;然而,差异无统计学意义,且两组HMGB1水平均显著高于ICU组和健康对照组。存活和非存活患者的HMGB1水平无显著差异。就脓毒症的病因而言,下呼吸道感染(LRTI)和尿路感染(UTI)患者的HMGB1水平无差异。

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