心理应激及HSP70与骨折愈合延迟的关联性研究

Association study of psychological stress and HSP70 with delayed fracture healing

目的探讨心理应激及热应激蛋白HSP70与骨折愈合延迟的关联性。方法选择骨折患者分为对照组(愈合正常)和病例组(愈合延迟),每组100例。采用症状自评量表(SCL-90)对研究对象进行心理健康状况分析,采用酶联免疫吸附法检测2组患者血清HSP70的表达水平。结果病例组和对照组患者在躯体化、人际关系、抑郁、焦虑、恐惧5个因子比较差异有统计学意义(P<0.05);与对照组比较,病例组患者血清HSP70因子表达升高(P<0.05);HSP70与抑郁和恐惧呈正相关性(P<0.05);在心理应激层面,多因素Logistic回归分析显示,患者躯体化(OR=2.81)、人际关系敏感(OR=1.62)及HSP70(OR=2.33)是影响骨折患者愈合程度的危险因素。结论骨折患者愈合延迟组心理应激水平高于愈合正常组,血清HSP70可能是骨折患者心理应激程度及愈合延迟的重要监测指标。

Objective To explore the association of psychology stress and HSP70 with delayed fracture healing. Methods All subjects for this study matched with the inclusion criteria were allocated randomly into the normal group and the delayed fracture healing groups. The general Symptom Checklist-90（SCL-90） was used to analyze the mental status of the patients. The expression level of serum HSP70 were detected by Elisa. Results Five factors（somatization,interpersonal sensitivity,depression,anxiety and phobic anxiety） of SCL-90 were found to be statistically different（P〈0.05） between the two groups. Compared to the control group,the serum HSP70 was expressed a higher level（P〈0.05）. The concentration of serum HSP70 was positively correlated with depression and phobic anxiety（P〈0.05）. In the perspective of psychological stress,logistic regression analysis revealed that somatization（OR = 2. 81）,interpersonal sensitivity（OR = 1. 62） and serum HSP70（OR = 2. 33） were all important factors of the delayed fracture healing.Conclusion Psychological stress has been positively associated with the delayed fracture healing. Serum HSP70 may be the monitoring index of the psychological stress and delayed fracture healing.