病毒性脑炎患儿血清高迁移率族蛋白-1与神经损伤和炎症反应的相关性研究

Correlation of blood high-mobility group box 1 protein with nerve injury and inflammatory response in children with viral encephalitis

摘要:

目的 探讨病毒性脑炎患儿血清高迁移率族蛋白-1（HMGB1）与神经损伤和炎症反应的相关性。方法 选取2019年10月—2021年10月襄阳市中心医院收治的94例病毒性脑炎患儿作为研究组。根据研究组神经损伤程度细分为轻度组37例，中度组31例，重度组26例。另取同期该院健康体检儿童86例作为对照组。测定所有研究对象血清HMGB1、神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、白细胞介素1β（IL-1β）、肿瘤坏死因子-α（TNF-α）水平，采用Pearson相关性分析病毒性脑炎患儿血清HMGB1水平与NSE、MBP、IL-1β、TNF-α水平的相关性，采用受试者工作特征（ROC）曲线分析病毒性脑炎患儿血清HMGB1水平对重度神经损伤的诊断效能。结果 研究组血清HMGB1、NSE、MBP、IL-1β、TNF-α水平高于对照组（P <0.05）。重度组血清HMGB1、NSE、MBP、IL-1β、TNF-α水平高于中度组和轻度组（P <0.05），中度组高于轻度组（P <0.05）。Pearson相关性分析结果显示，病毒性脑炎患儿血清HMGB1水平与NSE、MBP、IL-1β、TNF-α水平呈正相关（r =0.445、0.391、0.354和0.386，均P <0.05）。ROC曲线分析结果显示，病毒性脑炎患儿血清HMGB1水平评估重度神经损伤的最佳截断点为20.28 ng/mL，敏感性为88.46%（95% CI：0.698，0.976），特异性为94.12%（95% CI：0.856，0.984），AUC为0.948（95% CI：0.882，0.983）。结论 病毒性脑炎患儿血清HMGB1水平与神经损伤和炎症反应密切相关，血清HMGB1水平可作为评估患儿神经损伤的敏感指标。

Abstract:

Objective To investigate the relationship between blood high mobility group box 1 protein (HMGB1) and nerve injury and inflammatory response in children with viral encephalitis.Methods A total of 94 children with viral encephalitis admitted to the hospital from October 2019 to October 2021 were selected and included as the study group. According to the degree of nerve injury, they were subdivided into mild group (37 cases), moderate group (31 cases), and severe group (26 cases). In addition, 86 healthy children who came to the hospital for heath checkup during the same period were selected as the control group. Serum levels of HMGB1, neuron-specific enolase (NSE), myelin basic protein (MBP), interleukin-1β (IL-1β), and tumor necrosis factor alpha (TNF-α) were measured in all children. Pearson method was used to analyze the correlations between the serum level of HMGB1 and the serum levels of NSE, MBP, IL-1β and TNF-α in children with viral encephalitis. The receiver operating characteristic (ROC) curve was applied to analyze the value of serum HMGB1 levels in children with viral encephalitis in diagnosing severe nerve injury.Results The serum levels of HMGB1, NSE, MBP, IL-1β and TNF-α in children with viral encephalitis were higher than those in healthy children (P < 0.05), and they were also higher in the severe group than those in the moderate and mild groups (P < 0.05). Besides, the serum levels of these indicators were even higher in the moderate group than those in the mild group (P < 0.05). Pearson correlation analysis showed that serum levels of HMGB1 were positively correlated with those of NSE, MBP, IL-1β, and TNF-α in children with viral encephalitis (r = 0.445, 0.391, 0.354 and 0.386, all P < 0.05). ROC curve analysis showed that the optimal cut-off point of the serum HMGB1 level was 20.28 ng/mL for diagnosing severe nerve injury in children with viral encephalitis, with a sensitivity of 88.46% (95% CI: 0.698, 0.976), a specificity of 94.12% (95% CI: 0.856, 0.984), and an area under the ROC curve (AUC) of 0.948 (95% CI: 0.882, 0.983).Conclusions The serum level of HMGB1 is closely related to nerve injury and inflammatory response in children with viral encephalitis. Thus, it can be used as a sensitive indicator for evaluating nerve injury in these children.