Study On XueBi Jing Injection To Serum High-mobility Group Box-1 Protein Levels And Clinical Significance Of Patients With Severe Craniocerebral Injury Result In Secondary Pulmonary Infection

Objective:By monitoring and analysis the relationship between serum HMGB1 levels in patients with STBI and secondary pulmonary infection.to investigate the mechanism of pulmonary inflammatory response after traumatic brain injury.Through observing the changes of serum HMGB1 levels after the treatment by Xuebijing injection.to investigate the mechanism of Xuebijing Injection on STBI patients with secondary pulmonary infection.Methods:68 STBI patients as the research object, age from 18 to 70 years(47.51±14.558), admission GCS from 3 to 8 (5.78±1.619). All patients were measured with GCS, temperature, WBC, CRP, PCT, TNF-alpha, HMGB1 levels at the time of admission. And then recorded the operation and tracheotomy.17 cases died of primary injury within first week,27 cases acquired pulmonary infection within one month,and 24 cases were not. GCS, temperature,WBC, CRP, PCT, TNF-alpha, HMGB1 were measured when detected pulmonary infection, and not infected ones were detected once a week of the above physical and chemical indicators.27 cases of patients were diagnosed pulmonary infection. The subjects were randomly divided into experimental group (Xuebijing injection combined with antibiotics treatment,14 cases) and control group (antibiotics treatment.13 cases). Both of the group were measured with GCS, temperature,WBC, CRP, PCT, TNF-alpha, HMGB1 before and after treatment. All patients were recorded GOS at the end of one month cure.Results:The age (r=-0.411) and PCT (r=-0.46) level were negatively correlated with GOS of 68 cases, however GCS was positively related (r=0.593), P value was less than 0.05. After admission, surgery treatment, the trachea incision and there was no correlation between GOS. Age (P<0.05), and tracheotomy existed significant difference (P<0.01) between STBI with secondary pulmonary infection group (27 cases) and non-infection group (24 cases), but gender, operation were no difference (P>0.05).There were significant difference (P<0.05) between the two groups in temperature and serum PCT level, P value was less than 0.05. When diagnosis of pulmonary infection, temperature, WBC, CRP, PCT, TNF-alpha, HMGB1 were difference (P<0.05).Meanwhile, HMGB1 levels of pulmonary infection compared with others were increased multiples. STBI with secondary pulmonary infection in patients got worse prognosis (P<0.05).There was no difference of general information between the experimental group and control group, P value was more than 0.05. Before treatment in two groups,there were no statistical difference between temperature. WBC, CRP, PCT. TNF alpha. HMGB1 (P>0.05). After one week of treatment, serum TNF-a level has significant difference between the two groups (P< 0.05).Compared the difference index before and after treatment,we found that TNF-a existed difference (P<0.05), HMGB1 had significant difference (P< 0.01).Conclusion:1. Physical and chemical indicators of STBI with secondary pulmonary infection had varying degrees of elevation compared with the non infected groups, but the level of HMGB1 was significantly higher than other indicators. It is suggested that the monitoring of HMGB1 in patients with STBI is helpful to determine the occurrence of pulmonary infection. 2. Serum TNF-a and HMGB1 decreased significantly after the treatment of Xuebijing injection. However.the HMGB1 declined more significantly, which indicats that Xuebijing injection can effectively reduce the serum levels of TNF-alpha and HMGB1. 3. Xuebijing Injection by lowering the serum TNF-a and HMGB1 levels to control the inflammation, can become the ideal adjuvant drug in treating STBI with secondary pulmonary infection.