热休克蛋白70与严重多发伤后早期继发性肝脏损害

Study on the relationship of heat shock protein 70 with secondary liver damage in early stage after severe multiple injury

目的 :探讨热休克蛋白 70 (HSP70 )在严重多发伤后肝脏继发性损害中的作用。方法 :成年雄性 Wistar大鼠 ,采用严重胸部撞击伤伴单侧股骨骨折多发伤模型。动态观察致伤后 2 4 h及用糖皮质激素受体阻断剂米非司酮后大鼠肝组织 HSP70、肝功能指标及致伤 2 4 h死亡率等变化。HSP70表达测定采用免疫印迹法 ,并进行计算机图像分析。结果 :伤后 HSP70在肝组织中表达伤后迅速增加 ,8h达到峰值 ,2 4 h仍维持在较高水平 ;但血清丙氨酸转氨酶 (AL T)、总胆红素 (TB)及白蛋白的改变无显著差异。使用糖皮质激素受体阻断剂米非司酮能使肝组织 HSP70表达明显增多 ;血清 AL T及 TB在伤后早期即有明显升高 (P均 <0 .0 1) ,白蛋白明显下降(P<0 .0 1) ;伤后 2 4 h动物死亡率明显增加 (P<0 .0 1)。结论 :HSP70可能参与了肝组织细胞抗损伤机制的启动 ,但 HSP70过高表达则可能对肝脏造成损害。 HSP70可作为创伤后肝损伤与抗损伤机制的一个重要指标。

Objective:To study the action of heat shock protein 70 (HSP70) in the course of secondary hepatic injury in rats in the early stage after multiple injury.Methods:Adult male Wistar rats were used and rat model was produced by adopting severe thoracic impact injury in accompany with mono femur fracture.Changes of the content of HSP 70 in the hepatic tissue,hepatic function markers in serum were dynamically observed as well as 24 hours mortal rate after severe multiple injury,trauma with glucocorticoid receptor(GR) blocked.The expression of HSP70 in hepatic tissue was assayed by western blot and then analyzed with computer imaging system.Results:The content of HSP70 gradually increased in hepatic tissue after severe trauma,increased to the highest at 8 hours after trauma,and maintained rather high level at 24 hours after trauma.But the alterations of hepatic function markers in serum were not obvious after trauma.After usage of GR blocking agent,The content of HSP70 was much higher than simple trauma group.Alanine aminotransferase (ALT) and total bilirubin(TB) in serum obviously increased in early stage after trauma(both P <0.01),albumin content obviously decreased( P <0.01),while 24 hours mortal rate obviously increased ( P <0.01). Conclusion: HSP70 may participate in starting a antiinjury mechanism of hepatic tissue cell.But excessive expression of HSP70 may cause injury to liver after severe multiple injury.HSP70 can be identified as an important marker of liver injury and antiinjury after severe multiple injury.