重症急性颅脑外伤患者早期血浆热休克蛋白70的表达及其意义

HSP 70 in patients with acute severe craniocerebral trauma

目的探讨重症急性颅脑外伤患者早期血浆热休克蛋白70（HSP70）水平变化趋势及其对临床预后的影响。方法22例重症急性颅脑外伤患者为研究组，入院后进行格拉斯哥评分及急性生理学与慢性健康状况评分Ⅱ评分，在入院第1、2、3、4天用酶联免疫吸附方法检测血浆中HSP70含量，记录患者全身炎性反应综合征、多器官功能障碍综合征发生的情况及预后。22例研究组患者根据生存情况分为生存组11例和死亡组11例。结果重症急性颅脑外伤患者血浆HSP70水平第3天表达达到高峰，较第1、4天有统计学意义（P〈0．01）；生存组较死亡组HSP70水平在入院第2～4天时，增加明显（P〈0．01）。2组1周的SIRS的发生率无统计学意义（P〉0．05），MODS发生率有统计学意义（P〈0．05）。结论重症急性颅脑外伤患者早期HSP70表达增加对机体有保护作用，可作为早期判断预后的指标。

Objective To investigate the changes of serum HSP 70 in patients with acute severe craniocerebral trauma. Methods Twenty two patients with acute severe eraniocerebral trauma were evaluated with Glasgow Coma Scale（ GCS）, Acute physiology and chronic health evaluation（ APACHE Ⅱ ）score in intensive care unit. Serum HSP 70 was detected by enzyme linked immunosorbent assay （ELISA） during the first four days. Results The levels of serum HSP 70 on the 3rd day in patients with acute severe eraniocerebral trauma were significantly higher than that on the first and fourth days. There was significant difference in serum HSP 70 between survival group and dead group between the 2nd and 4th days. The ratio of SIRS had no obvious ehanges between survival group and dead group in one week, but the ratio of MODS decreased significantly in survival group. Conclusion The early high level of serum HSP 70 is a possible protection for patients with acute severe eraniocerebral trauma,which is correlated with prognosis of patients.