Application Value Of Serum HMGB1 In Patients With AECOPD Complicated With Pulmonary Hypertension

Objective:To study the expression level of serum high mobility group protein B1（HMGB1）in acute exacerbation of chronic obstructive pulmonary disease with pulmonary hypertension（AECOPD-PH）patients,analyze the correlation between HMGB1 and serological parameters,and explore the value of HMGB1 in AECOPD-PH.Methods:127 patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）who were hospitalized in the Department of Respiratory and Critical Care Medicine at Shanxi Baiqiuen Hospital from June 2021 to September 2022 were selected as study subjects,and information on general data,transthoracic echocardiographic（TTE）indexes,and other information of patients were recorded.Measuring the serum HMGB1,IL-6,ET-1,TNF-αand VEGF levels at fasting on the second day of admission.According to the TTE test results,to assess the likelihood of PH occurrence,the high likelihood PH was included in the AECOPD-PH group（56 cases）,and the other were included in the AECOPD group（71 cases）.The general data,laboratory indexes and serological index levels of the two groups were compared,and multivariate binary Logistic regression analysis was performed on the indicators with differences between the two groups,so as to clarify the influencing factors of AECOPD-PH,draw ROC curve,and calculate the area under the curve（AUC）.According to the simplified risk stratification scale,patients with AECOPD-PH were divided into a low-risk group（17 cases）and a medium-high risk group（39 cases）.The general data,laboratory indexes and serological indexes of the two groups were compared,and the different indexes between the two groups were analyzed by multivariate binary Logistic regression.The influencing factors of risk stratification in AECOPD-PH patients were determined,and the optimal threshold of serum HMGB1 in risk stratification in AECOPD-PH patients was predicted by ROC curve analysis.Results:Serum HMGB1,ET-1 and Pa CO₂in AECOPD-PH group were significantly higher than those in AECOPD group.ROC curve analysis results showed that serum HMGB1,ET-1 and Pa CO₂had certain value in predicting AECOPD-PH,and the combined prediction value of the three factors was the highest.Serum HMGB1 in the medium-high risk AECOPD-PH group was significantly higher than that in the low-risk AECOPD-PH group.The area under ROC curve（AUC）of serum HMGB1 in the assessment of high-risk AECOPD-PH was 0.7,and the optimal threshold was 38.24 ng/m L.Serum HMGB1 is significantly positively correlated with IL-6 and TNF-α,and negatively correlated with VEGF.Conclusions:1.Serum HMGB1 increased in patients with AECOPD-PH group,which is one of the risk factors for AECOPD-PH,and the combined prediction value of HMGB1,ET-1 and Pa CO₂is the highest.2.Serum HMGB1 may be a predictor of AECOPD-PH,and has a certain value for PH risk stratification.3.Serum HMGB1 was significantly correlated with IL-6,TNF-αand VEGF in AECOPD-PH.