Plasma high-mobility group box 1 as an indicator of surgical stress
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High-mobility group box 1 (HMGB-1) is a late-phase cytokine, which is released extracellularly in response to systemic inflammation caused by infection, shock, or trauma. We examined the plasma levels of HMGB-1 to clarify its role in surgical stress.
The subjects of this study were 37 patients who underwent elective general surgery. We measured plasma concentrations of HMGB-1 over time using a quantitative enzyme-linked immunosorbent assay. We then analyzed the relationships between the change in HMGB-1 concentration and perioperative factors, including postoperative complications. Statistical analyses were performed using two-way repeated-measures analysis of variance.
The HMGB-1 level was higher on postoperative day 3 in patients with a prolonged operative time or large intraoperative blood loss (P = 0.048 and P = 0.041, respectively). The HMGB-1 level also remained high over time in patients with postoperative complications (P = 0.037).
These results show that the plasma HMGB-1 level is related to surgical stress such as operative time and blood loss. The level remained high over time in patients with postoperative complication, suggesting progression of the complication.
Key wordsPlasma high-mobility group box 1 Surgical stress Perioperative period Postoperative complications
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