HMGB1 In Patients With Intestinal Mucosal Barrier Injury In Sepsis Expression In Research

Objective: To investigate the expression levels of high mobility group box 1 protein(HMGB1)in patients with intestinal mucosal barrier injury in sepsis.Methods:(1)According to the 2016 Chinese sepsis/septic shock guideline standards,patients diagnosed with sepsis after admission to the Department of Critical Care Medicine of Guangxi Zhuang Autonomous Region People’s Hospital from July 2021 to December 2022 were selected,and 47 patients who met the diagnostic criteria for sepsis were finally selected as the observation group(19 cases in the sepsis non-shock group and 28 cases in the sepsis shock group)according to the inclusion criteria and exclusion criteria,and 20 healthy people(9 males and 11 females)were selected as the control group.According to the definition and grading criteria of acute gastrointestinal injury(AGI)proposed by the European Society of Critical Care Medicine in 2012,the observation groups were grouped,including AGI I(19cases),AGI II(11 cases),AGI III(17 cases),and AGI IV(0 cases).(2)Serum samples from the 24 h,48h,and 72 h of the observation group were collected,and serum samples from the24 h of the control group were collected at the same time,and the serological indexes of the24 h,48h,72 h of the observation group and the 24 th h of the control group were detected by enzyme-linked immunosorbent assay(ELISA): high-mobility group protein B1(HMGB1),diamine oxidase(DAO),intestinal fatty acid binding protein(IFABP),the general data of the observation group,acute physiology and chronic health evaluation II(APACHE II)score,sequential organ failure assessment(SOFA)score,inflammatory indexes,biochemical indexes and blood gas analysis.(3)Comparing the changes of the above indexes and scores,the correlation between HMGB1 and the intestinal mucosal barrier index of sepsis was preliminarily explored by statistical methods,and the changes of the expression levels of HMGB1,IFABP and DAO in different AGI grades were explored,and the receiver opeartor characteristic curve(ROC curve)was applied according to Logistic regression analysis.To assess the predictive value of HMGB1 for the severity of sepsis disease.Results: The expression levels of serum HMGB1 in the observation group at different time points were correlated with the corresponding intestinal mucosal injury indexes DAO and IFABP at different time points(r values at different time points of DAO were r 24=0.782,P<0.05;r48=0.643 P<0.05;r72=0.756 P<0.05;r values at different time points of IFABP were r24=0.699,P<0.05;r48=0.603,P<0.05;r72=0.681,P <0.05);The serum levels of HMGB1,DAO and IFABP at 24 h,48h and 72 h in the observation group were significantly higher than those in the control group(P<0.05),and the serum HMGB1 expression levels in the septic shock group at 24 h,48h and 72 h were higher than those in the septic non-shock group(P <0.05);In different AGI groups,the higher the AGI grade,the higher the expression levels of serum HMGB1,DAO and IFABP.Logistic regression analysis showed that HMGB1 was an independent risk factor affecting the severity of sepsis,and combined with the ROC curve of the observation group,it was found that the area under the curve of serum HMGB1 at 24 h for the diagnosis of sepsis was large(AUC 0.853,95% CI = 0.749-0.958),indicating that HMGB1 may have predictive value on the severity of sepsis.Conclusion: Serum HMGB1 predicts sepsis severity;HMGB1 was positively correlated with DAO and IFABP in patients with intestinal mucosal barrier injury in sepsis.The higher the AGI grade,the higher the expression levels of HMGB1,DAO,and IFABP.