Lu Huasong, Zeng Nengyong, Chen Quanfang, Wu Yanbin, Cai Shuanqi, Li Gengshen, Li Fei, Kong Jinliang
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Respiratory Medicine, The Second People's Hospital of Qinzhou, Qinzhou, Guangxi, China.
J Int Med Res. 2019 Mar;47(3):1232-1240. doi: 10.1177/0300060518819381. Epub 2019 Feb 7.
To investigate the relationship between serum high mobility group box-1 protein (HMGB-1) levels and prognosis in patients with community-acquired pneumonia (CAP).
This prospective study included 35 patients who attended our hospital from January 2016 to December 2016. Pneumonia severity was defined by pneumonia severity index (PSI). Serum levels of C-reactive protein (CRP), cortisol, and HMGB-1 were analyzed in relation to disease severity and clinical outcome.
High HMGB-1 levels were associated with high cortisol levels. High HMGB-1 and high cortisol were both significantly associated with high white blood cell count and high serum CRP, compared with low HMGB-1 and low cortisol, respectively. PSI score and 30-day mortality were also significantly higher in patients with high HMGB-1 or high cortisol levels compared with patients with low HMGB-1 or cortisol levels, respectively. CRP, cortisol, and HMGB-1 levels were all significantly higher in patients who died compared with survivors.
HMGB-1 was associated with clinical outcomes and was an independent risk factor for 30-day mortality in patients with CAP. Serum HMGB-1 levels were also positively correlated with serum levels of cortisol. These results demonstrate a role for HMGB-1 in CAP, and suggest possible new therapeutic targets for patients with CAP.
探讨血清高迁移率族蛋白B1（HMGB-1）水平与社区获得性肺炎（CAP）患者预后的关系。
这项前瞻性研究纳入了2016年1月至2016年12月在我院就诊的35例患者。肺炎严重程度采用肺炎严重指数（PSI）进行定义。分析血清C反应蛋白（CRP）、皮质醇和HMGB-1水平与疾病严重程度及临床结局的关系。
高HMGB-1水平与高皮质醇水平相关。与低HMGB-1和低皮质醇相比，高HMGB-1和高皮质醇均分别与高白细胞计数和高血清CRP显著相关。与低HMGB-1或皮质醇水平的患者相比，高HMGB-1或高皮质醇水平的患者PSI评分和30天死亡率也显著更高。与幸存者相比，死亡患者的CRP、皮质醇和HMGB-1水平均显著更高。
HMGB-1与临床结局相关，是CAP患者30天死亡率的独立危险因素。血清HMGB-1水平也与皮质醇血清水平呈正相关。这些结果证明了HMGB-1在CAP中的作用，并为CAP患者提示了可能的新治疗靶点。
