The Relationship Between The Expression Of Serum HMGB1 And Early Brain Injury After Subarachnoid Hemorrhage

Objective:To explore the relationship between the expression of serum high mobility group protein B1(HMGB1)and early brain injury after subarachnoid hemorrhage(SAH).Methods:Sixty-nine patients hospitalized in neurosurgery at the First and Second Clinical Medical College of Inner Mongolia University for Nationalities from November 2021 to November 2022 were selected,and 12 cases with data loss and lost access conditions were removed,leaving 57 patients included in the study.According to the Hunt-Hess grading method,the patients were divided into good admission group(Hunt-Hess grade I-III,38 cases)and poor admission group(Hunt-Hess grade IV and V,19 cases),and elbow venous blood was drawn at the time of admission,1 d and 3 d after admission for the detection of serum HMGB1 content to statistically analyze the serum expression of HMGB1 in patients with different admission conditions.The expression of HMGB1 and its significance were analyzed.According to the Modified Rankin Scale(m RS),the good admission group was divided into good prognosis group-1(m RS grade 0～2,24 cases)and poor prognosis group-1(m RS grade 3～5,death,14 cases),and the poor admission group was divided into good prognosis group-2(m RS grade 0～2,5 cases)and poor prognosis group-2(m RS grade3～5,death,14 cases).m RS grade 3～5,death,14 cases),and the levels of HMGB1 expression in serum of different subgroups and their significance were statistically analyzed separately.Results:Comparing the general data of the two groups,it was found that there were no statistically significant differences in gender,age,disease duration,body mass index,aneurysm location,history of hypertension,history of smoking,and history of alcohol consumption in the two groups,respectively(P>0.05);the serum HMGB1 levels at admission,1d and 3d after admission in the group with good prognosis were lower than those in the group with poor prognosis,and the differences were statistically significant(P<0.05),and the serum HMGB1 levels at 1d after admission and 3d after admission in the same group The serum HMGB1 levels of the same group were all different from those at the time of admission,which was statistically significant(P<0.05);the serum HMGB1 levels of the good prognosis group-1 and good prognosis group-2 at the time of admission were lower than those of the poor prognosis group-1 and poor prognosis group-2,and the differences were statistically significant(P<0.05),and the serum HMGB1 levels of the good prognosis group-1 at 1 d after admission and 3 d after admission were The differences were statistically significant(P<0.05),while the differences between the serum HMGB1 levels in the good prognosis group-2 and the poor prognosis group-2 were not statistically significant(P>0.05),and the differences between the serum HMGB1 levels in the same group in the 1d and 3d post-admission periods were statistically significant(P<0.05).);serum HMGB1 concentration 1 d after admission had a good predictive value for prognosis,with an AUC of 0.813 ± 0.075(P=0.002,95% CI:0.667-0.960),and the best cut-off point was 86.73 μ g/ml,at which time the sensitivity was 76.95% and the specificity was 71.44%;while the other time points serum HMGB1 concentrations had no significant predictive value for patient prognosis,with AUC values less than 0.7 and P values > 0.05,with no statistically significant differences.Conclusions :The level of serum HMGB1 is closely related to the degree of early brain injury after SAH,which may be an auxiliary indicator for the early evaluation of the condition and prognosis of brain injury after SAH.