The Level And Significance Of Serum High Mobility Group Protein 1 In Children With Sepsis And Septic Shock

Objective:To study the level difference of high mobility group protein 1 in childhood sepsis and septic shock and its predictive value for septic shock,and to compare and analyze with traditional inflammatory markers.Methods:Part of the children hospitalized from PICU in shengjing Hospital of China Medical University from December 2019 to December 2020 were selected as the research objects.They were divided into non-infectious group,29 cases,sepsis group,32 cases,and septic shock group,14 cases.For example,the child’s general information,laboratory indicators,and length of stay were collected,and recorded into the PICU within 24 hours of PRISM Ⅲ score and PCIS score;the serum was collected within 24 hours of hospitalization,and the HMGB 1 value was detected by the double antibody sandwich ELISA method.Compare the diagnostic value of HMGB 1 and traditional infection indexes for children with sepsis and septic shock,and the correlation between HMGB1 and traditional infection indexes,cytokines and critical illness score.Results: The analysis of variance of HMGB 1 levels in the three groups of children indicated that it was statistically significant.Further pairwise comparisons indicated that the P value between septic shock and sepsis group,septic shock and non-infectious group was <0.05,but P=0.304 between the toxic group and the non-infected group,the difference was not statistically significant.There were statistical differences in HMGB 1,CRP,PCT,IL-6,and white blood cell counts between the infected group(sepsis and septic shock)and the non-infected group.In the value analysis that distinguishes the infected group from the non-infected group,CRP has the largest value and HMGB 1 has the smallest value.There was no statistically significant difference between the septic shock group and the sepsis group in the comparison of general data such as gender and age;the median hospital stay in the septic shock group was 19 days,which was longer than 9.5 days in the sepsis group;The PRISM Ⅲ scorein the septic shock group is higher than that of the sepsis group,and the PCIS score is lower than that of the sepsis group.The difference is statistically significant.In the comparison of inflammatory markers between the two groups,white blood cell count and CRP are not statistically different.HMGB 1,PCT and IL 6 in the septic shock group are higher than the sepsis group,and the difference was statistically significant.In the ROC curve analysis for predicting shock in children with sepsis,the AUC of IL6 is 0.806,which is the most specific.When the cut-off value of HMGB 1 is 191.63ng/m L,the AUC is 0.724 and the sensitivity is the highest.Among the combined predictions,HMGB 1 combined with IL6 has the greatest predictive value for septic shock,with an AUC of 0.859.Correlation analysis results indicate that HMGB 1 is related to interleukin 2,interleukin 6,interleukin 10,interleukin17,INF-γ,Lactic acid,PRISM Ⅲ score,and PCIS score,and the difference is statistically significant,except for the negative correlation with PCIS score,The rest are positively correlated.Conclusion:The value of HMGB 1 in distinguishing the infection group(sepsis and septic shock)from the non-infectious group is less than traditional inflammatory markers,but it has the highest sensitivity in predicting septic shock,and its predictive value combined with IL-6 is largest,and HMGB 1 is related to a number of cytokines,and is positively related to the severity of the disease.