心肺脑复苏后患者脑损害与热休克蛋白70的相关性

Correlation of heat shock protein 70 with brain injury after cardio pulmonary cerebral resuscitation

目的探讨心肺脑复苏后患者发生脑损害与其自身的热休克蛋白70(Heat shock protein 70,HSP70)的相关性。方法随机选取湖北省中西医结合医院2013年6月—2015年2月收治的心肺脑复苏成功患者60例作为复苏组,另选60例健康人员作为对照组,对复苏组患者进行2h、5h、12h、24h、48h的动态HSP70测定,并对患者进行同一时间段颈静脉血氧饱和度(Oxygen saturation of jugular venous blood,Sjv O2)的监测,分析HSP70与Sjv O2的相关性。结果进行心肺脑复苏的患者其HSP70的测得值在复苏后几小时即显著升高,于5h达到峰值,各个时间段的测定值均显著高于对照组(P<0.01);复苏后2h、5h、12h、24h、48h这些时间段的HSP70值与患者的Sjv O2值存在显著正相关(P<0.01)。患者清醒所需时间越短,其HSP70水平越高。结论热休克蛋白70是具有细胞保护作用的应激蛋白,Sjv O2值越低,HSP70值亦越低,脑损伤越重,其与心肺脑复苏后患者的脑损害程度存在相关性,可用于心跳骤停早期昏迷患者的脑损害估计。

Objective To investigate the correlation between brain damage of patients after cardiopulmonary cerebralresuscitation and heat shock protein 70（HSP70）. Methods Sixty patients with successful cardiopulmonary cerebralresuscitation were randomly selected from Hubei Provincial Hospital from Jane 2013 to February 2015 as recovery group,and60 healthy individuals served as the control group. HSP70 levels were measured dynamically at 2h,5h,12 h,24h and 48 h,andthe oxygen saturation of jugular venous blood（Sjv O2）was monitored at the same time. Correlation between HSP70 and Sjv O2 was analyzed statistically. Results HSP70 rose significantly in a couple of hours after recovery of cardiopulmonary cerebralresuscitation patients,and peaked at 5h,and measurements at all time points were significantly higher than those of controlgroup（P〈0.01）. HSP70 positively correlated with Sjv O2 at 2h,5h,12 h,24h and 48 h after recovery（P〈0.01 respectively）. Theshorter it took for the patient to wake up,the higher the HSP70 levels were. Conclusion HSP70 is a stress protein with cellprotective effect. The lower the Sjv O2 value is,the lower HSP70 levels are,and the severer the brain injury is. Thus HSP70 correlates with the extent of brain damage in patients after cardiopulmonary cerebral resuscitation,and can be applied toestimate brain damage in early coma patients after cardiac arrest.