糖尿病与非糖尿病急性创伤病人热休克蛋白72不同表达对预后的影响

The Different Expression of Heat Shock Protein 72 in Leukocytes from Early Acute Trauma Diabetes Patients and No-diabetes Patients

目的 研究急性创伤病人应激早期各时段糖尿病组和非糖尿病组中性粒细胞中热休克蛋白72（HSP72）编码基因的表达，以探讨热休克蛋白72不同表达对于两组病人预后的影响以及其他相关因素。方法随机选取收入ICU的A—PACHEⅢ评分≥18分的病人38例，分为糖尿病组和非糖尿病组，分离创伤后0～1天、2～6天、7～14天的中性粒细胞，RT—PCR方法检测HSP72m RNA含量，比较各组间的变化，记录病人2个月存活率。研究HSP72增高与预后的关系。结果HSP72在急性应激后表达明显增强，表达高峰在2～6天，非糖尿病人组较糖尿病组，HSP72的表述水平明显增高，且存活率较高。结论HSP72的基因水平检测可以作为判断重症病人预后的客观指标。

Objective To determine the expression of heat shock protein 72 in leukocytes from early acute trauma patients both the diabetes group and no-diabetes group, evaluate its relationship with the survival and study the clinical significance of the expression level. Methods 38 acute trauma patients （ APACHEⅢ≥18） from ICU randomly were included the diabetes group and no-diabetes group in test. Blood samples were serially obtained at three time points： days 0-1 ,days 2-6 and days 7-14 after the trauma event. We evaluated the expression of HSP72 mRNA by RT-PCR in leukocytes,find out the peak point of expression and the relationship between its level and the survival （survival period〉2 months） was analyzed. Results The expression of HSP72 was significantly enhanced on post-trauma days 2-6. The level of HSP72 in the no-diabetes group was higher than that in diabetes group and the no-diabetes group had a higher survival rate. Conclusion The study suggests that the acute trauma patients can lead to a marked elevation of HSP72 and its peak level is on days 2-6,which might be associated with higher survival rate of no-diabetes group patients.