HMGB1是急性损伤中死亡率的预后因素,需要脏替代疗法治疗
Ryo Matsuura1, Yohei Komaru1, Yoshihisa Miyamoto1
1Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.
Blood purification
|June 19, 2023
概括
高流动性组框1 (HMGB1) 与急性损伤 (AKI) 患者的死亡率有关,这些患者需要持续置换疗法 (CRRT). 具有经典CRRT启动的高HMGB1水平表明风险最高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 分子生物学分子生物学
背景情况:
- 高流动性组盒1 (HMGB1) 是一种促炎性细胞因子,在急性损伤 (AKI) 的动物模型中与器官损伤有关.
- HMGB1与AKI患者的临床结果之间的关联,特别是那些需要持续脏替代疗法 (CRRT) 患者,仍在研究中.
研究的目的:
- 调查血HMGB1水平与接受CRRT的AKI患者的预后之间的关系.
- 确定HMGB1水平是否可以预测该患者群体的死亡率.
主要方法:
- 在2013-2016年期间接受CRRT的177名AKI患者的队列中,在治疗开始时测量了血HMGB1.
- 患者根据CRRT (经典启动) 的常规指示与没有常规指示 (早期启动) 进行分类.
- 主要结局是90天死亡率,分析与HMGB1水平和CRRT启动时间相关.
主要成果:
- 血HMGB1水平与90天死亡率显著相关 (HR,1.06;95% CI,1.04-1.08).
- 与其他组相比,高HMGB1水平 (>10 ng/mL) 和经典CRRT启动的患者的90天死亡率明显更高,即使在调整非脏SOFA得分后.
- 接收器操作曲线 (ROC) 分析确定了HMGB1的切割值.
结论:
- 在需要CRRT的AKI患者中,HMGB1是90天死亡率的重要预测因子.
- 高HMGB1水平和经典CRRT启动的组合确定了一个具有最大死亡率的高风险子组.
- 这些发现表明,CRRT可能对高HMGB1的AKI患者有益,无论常规的适应症如何.
相关概念视频
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