Abstract:

Objective To study the correlation between the level of peripheral blood high mobility group protein B1（HMGB1） and respiratory distress syndrome（RDS） in premature infants,and to investigate the role of HMGB1. Methods A total of 80 cases of <32-week premature infants,80 cases of 32-37-week premature infants and 80 cases of >37-week infants were enrolled. The clinical data were collected. Enzyme-linked immunosorbent assay（ELISA） was used to determine HMGB1 levels in peripheral blood of infants at postnatal 6 and 24 h. Receiver operating characteristic（ROC） curve was used to evaluate peripheral blood HMGB1 level in the prognosis of children with RDS. Results The prevalence rate of RDS,the mortality rate and serum HMGB1 levels at postnatal 6 and 24 h in <32-week group were higher than those in 32-37-week group and >37-week group（P<0.05,P<0.01）,and those in 32-37-week group were higher than those in >37-week group（P<0.05,P<0.01）. Serum HMGB1 levels at postnatal 24 h in <32-week and 32-37-week groups were higher than those at postnatal 6 h（P<0.05）,while serum HMGB1 levels at postnatal 6 and 24 h in >37-week group had no statistical significance（P>0.05）. Serum HMGB1 levels in disease control group at postnatal 6 and 24 h were higher than those in >37-week group and 32-37-week group （P<0.05）,but they were lower than those in <32-week group （P<0.05）. There were 92 in 240 infants with RDS,including 60 cases of death and 32 cases of survival,and the other 148 infants were normal. In the disease control group,2 cases died,and 56 cases survived. Serum HMGB1 level at postnatal 6 h in death group was higher than those in survival group and normal infants（P<0.01）. Serum HMGB1 level in survival group was higher than that in normal infants（P<0.05）. Serum HMGB1 level of dead cases at postnatal 6 h in disease control group was higher than that of survived cases. There was no statistical significance between dead and RDS survived cases （P>0.05）. ROC curve analysis showed that the areas under ROC curves（AUC） of HMGB1 identifying RDS and normal infants and RDS survival and death were 0.88 and 0.81,respectively. The optimal cut-off values were 668.63 and 698.29 pg/mL,respectively. The sensitivities were 96.78% and 100.00%,respectively,and the specificities were 75.35% and 57.65%,respectively. Conclusions Serum HMGB1 level can reflect the disease progression of RDS and can be used as one of the indicators for RDS disease evaluation and prognosis.

Key words: High mobility group protein B1, Respiratory distress syndrome, Premature infant