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| Relationship between serum levels of high motility protein B1, ubiquitin carboxy-terminal hydrolase L1 and poor prognosis of neurological function after cardiopulmonary resuscitation |
| ZHOU Mengju1 XIAN Lina1▲ SUN Guangxiao1 CHEN Peiying1 GAO Na1 CHEN Taiming2 |
1.Department of Critical Medicine, the First Affiliated Hospital of Hainan Medical University, Hainan Province, Haikou 570100, China;
2.Emergency Intensive Care Unit, the First Affiliated Hospital of Hainan Medical University, Hainan Province, Haikou 570100, China |
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Abstract Objective To investigate the relationship between serum high motility protein B1 (HMGB1), ubiquitin carboxy-terminal hydrolase L1(UCH-L1) and poor prognosis of neurological function after cardiopulmonary resuscitation. Methods A total of 175 patients with spontaneous circulation recovery after cardiopulmonary resuscitation after cardiac arrest admitted to the First Affiliated Hospital of Hainan Medical College from January 2019 to October 2022 were selected as the study objects. The patients were divided into poor prognosis group (75 cases) and good prognosis group (100 cases). Serum HMGB1 and UCH-L1 levels and clinical data （gender, age, body mass index, mechanical ventilation time, smoking history, drinking history, history of previous underlying diseases, cause of cardiac arrest, recovery time of autonomic circulation, pre-hospital emergency time, kidney replacement therapy, Glasgow coma scale (GCS) score, acute physiology and chronic health Ⅱ [APACHEⅡ] score） were compared between the two groups. Multivariate logistic regression was used to analyze the factors affecting the prognosis of neurological function, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum HMGB1 and UCH-L1 for poor prognosis of neurological function. Results APACHE Ⅱ score, mechanical ventilation time, and serum HMGB1 and UCH-L1 in the poor prognosis group were higher than those in the good prognosis group, while GCS score was lower than that in the good prognosis group, with statistical significances (P＜0.05). Logistic multivariate regression analysis showed that HMGB1, UCH-L1, and APACHEⅡ scores were independent risk factors for poor prognosis of neurological function after cardiopulmonary resuscitation (OR＞1, P＜0.05). ROC curve analysis showed that HMGB1 combined with UCH-L1 was more effective in predicting poor neurological outcomes than HMGB1 and UCH-L1 alone (P＜0.05). Conclusion Serum HMGB1 and UCH-L1 levels are significantly increased in patients with poor neurological prognosis after cardiopulmonary resuscitation, which are independent risk factors for poor neurological prognosis. Combined detection is helpful for early assessment of poor neurological prognosis in patients.
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