| Objective:The purpose of this study is to explore the correlation between the level of serum HMGB1 and the severity and prognosis of acute pancreatitis by means of meta analysis,so as to provide a new way for the evaluation of disease severity and prognosis of acute pancreatitis.Methods:Through computer in English databases such as Pub Med,EMBASE,cochron library,web of Science and Chinese databases,such as How Net,Wanfang and other mainstream databases,are used for systematic literature retrieval.The retrieval time is from the establishment of the database to December 31,2019.All literatures related to the level of serum HMGB1 and the severity of acute pancreatitis and prognosis in this time are searched.The obtained literatures are screened according to the inclusion and exclusion criteria established in advance,and finally screened The literature quality was evaluated by NOS scale and the data in the literature was extracted.The extraction of literature data was completed by two researchers.Finally,we use Revman 5.0 statistical software to summarize and meta analyze the data.The I2 test method was used to test the heterogeneity among the studies.According to the heterogeneity test results,the appropriate effect model was selected for statistical analysis.If P<0.05,the meta analysis results had statistical significance.Results:Through the screening of inclusion criteria,17 articles were included in the study,and 1806 people were included in the study.In thisstudy,all the included literature samples have clear sources and strong comparability between groups.The quality scores of 17 literatures are all above 5 points,and the overall quality is high.12 of them compared the serum HMGB1 levels between map patients and healthy people.951 subjects were included,489 in map group and 462 in healthy control group.Results:SMD=2.77,95%CI(1.86,3.68),P<0.00001,the difference was statistically significant;13 studies compared the serum HMGB1 levels of SAP group and map group.928 subjects were included,including 405 in SAP group and 523 in map group.The combined SMD=3.11,95%CI(2.21,4.00),P<0.00001,the difference was statistically significant;there were 4 articles comparing the mean level of serum HMGB1 of SAP patients with organ failure and those without organ failure within 3 days after admission,totally 126 SAP patients were included,including 66 patients with organ failure and 60 patients without organ failure.After the combination[SMD=4.02,95%CI(2.59,5.46),P<0.00001,the difference was statistically significant;four studies compared the differences of serum HMGB1 levels of SAP patients with different clinical outcomes at admission,a total of 447 AP patients were included in the study,158 of them died and 289 survived.The combined MD=7.16,95%CI(2.37,11.94),P<0.00001,the difference was statistically significant.Conclusion:1.The level of serum HMGB1 has a significant correlation with the severity of AP;2.The level of serum HMGB1 has a significant correlation with the adverse prognosis of AP patients:the higher the concentration of serum HMGB1 in AP patients,especially in SAP patients,the easier it is to develop to the direction of adverse prognosis.By detecting the changes of HMGB1 concentration in SAP patients,we can find the trend of poor prognosis as early as possible,and then take intervention measures as early as possible. |
