| BackgroundThe frequency of occurrence in trauma brain injury with high-energy increased gradually coupling with the development of modern industry. The brain tissue edema and increased intracranial pressure after traumatic brain injury have resulted in higher mortality and morbidity. the attention of the intracranial pressure in clinic make all kinds of methods of monitoring of intracranial pressure developed.The introduction of FVEP noninvasive intracranial pressure monitor rapidly provides an important way to acquire intracranial pressure of patients with trauma brain injury timely, As the brain edema mechanism after trauma brain injury came to be known, various researchs and applications of molecular are put forward. The HMGBl’s role in inducing inflammation is being cognitive in recent years, although a variety of mechanisms is not entirely clear, it’s expression gradually attracts attention after trauma brain injury, the plasma concentration and its dynamic change regularity associated with intracranial pressure change is rarely studied in patients with different periods after trauma brain injury.This study focuses on plasma HMGB1 concentration change in different periods and different period of noninvasive intracranial pressure monitoring results to explore the correlation between them after traumatic brain injury.ObjectiveExplore the expression and regulation of plasma HMGB1 in different periods of patients with traumatic brain; explore the change regulation of Intracranial pressure value in different periods of patients with traumatic brain Injury; explore the correlation of change between plasma HMGB1 and intracranial pressure value in different time period.Materials and methods1 Object of studyUnder the supervision and agreement of the hospital ethics committee, we prospectively made an experimental design about patients with traumatic brain injury. These examples, including 33 males and 27 females and aging from 14 to 60, were treated between the year of 2012 and 2014 in people’s liberation army (PLA) 153 central hospital. The causes showed that these examples involved 21 patients suffering from traffic accidents injury,16 patients patients, suffering from High falling injury,14 patients suffering from bruises,6 patients suffering from Hurtful Strike,3 patients suffering from other factors; 32healthy people is chosen2 GroupingThese cases are divided into two group according to injury and health, The experimental group to meet the inclusion criteria of 60 patients with cerebral contusion, While 32cases healthy people consist of control group. The experimental group according to the injury severity and GCS score is divided into light craniocerebral injury group (12 to 15 points), medium craniocerebral injury group (9-12), severe craniocerebral injury group (3-8);According to the bilateral cerebral hemisphere noninvasive intracranial pressure difference (D value), The experimental group is divided into D value> mmh2o group and 60 D< 60 mmh2o group.3 MethodsWhen the experiment group patients are admitted to hospital, researchers measure intracranial pressure of patients by the FVEP intracranial pressure monitor,at the same time they collecting blood samples and extract the plasma. Then the plasma is saved in -80℃ environment. Similiarly they do the same operation in 1,3,6,9,12,15 days, plasma in lab is detected by ELISA for the concentration of HMGB1 in time. Control group is given FVEP noninvasive intracranial pressure monitoring, blood sampling and plasma extracting under the same condition as the experimental group. Researchers detect plasma by ELIS A for the concentration of HMGB1 as well, they give the experimental group patients CT scan in time, record the CT score and the size of the hematoma change4 Statistical analysisThe statistical software SPSS 17.0 was used to process the data. The data is described by mean± standard deviation. The quantitative material was analyzed by t testing and correlation between the two groups used single factor correlation analysis for data analysis. A criteria of α=0.05 was used for the testing, which means that when P was less than 0.05, the data had statistical meaning.Results1. Experimental group is compared with control group in plasma HMGB1 concentration: the concentration of plasma HMGB1 in experimental group is significantly higher than control group2. The experimental group is compared with control group in intracranial pressure: the intracranial pressure in experimental group is significantly higher than normal group3. The plasma HMGB1 expression of experimental group in different periods: quantity of plasma HMGB1 expression in early time of TBI increases gradually and decreases gradually after peak it reach, but quantity of plasma HMGB1 expression is higher than control group4. The Intracranial pressure value of experimental group in different periods: Intracranial pressure value in early time of TBI increases gradually and decreases gradually after peak it reach, but Intracranial pressure value is higher than control group.5. The plasma HMGB1 concentration in group of D value> 60mmh2o has obvious difference comparing with group of D value< 60 mmh2o:group of D value> 60mmh2o is significantly higher than group of D value< 60 mmh2o.6. The addition of hematoma and CT score in group of D value> 60mmh2o has obvious difference comparing with group of D value< 60 mmh2o:group of D value> 60mmh2o is significantly higher than group of D value< 60 mmh2o7. In patients with traumatic brain injury, intracranial pressure in light craniocerebral injury group, medium craniocerebral injury group and severe craniocerebral injury group intracranial pressure has significant differences among groups8. In patients with traumatic brain injury, plasma HMGB1 concentration in light craniocerebral injury group, medium craniocerebral injury group and severe craniocerebral injury group intracranial pressure has significant differences among groups9. Relationship between intracranial pressure value and plasma concentration of HMGB1 in contrl group have no relation; relationship between intracranial pressure value and plasma concentration of HMGB 1 in experimental group have high relationConclusion1. The plasma concentration of HMGB1 obviously increased after traumatic brain injury, and plasma HMGB1 concentration change in different periods have regularity.2. Increased intracranial pressure after traumatic brain injury is obviously higher, the D value can be more accurate description of intracranial injury situation and the changes of intracranial pressure.3. Intracranial pressure changes in patients with traumatic brain injury during different periods was correlated with plasma HMGB1 concentration change. |
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