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目的:研究糖尿病和非糖尿病急性创伤患者应激早期各时段热休克蛋白72(HSP72)编码基因的表达和对预后的影响。方法:随机选取收入ICU的A-PACHEIll评分≥18分的患者38例,分为糖尿病组和非糖尿病组,分离创伤后0~1 d、2~6 d、7~14 d的中性粒细胞,RT-PCR方法检测HSP72m RNA含量,比较各组间的变化,记录患者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 d,非糖尿病患者组较糖尿病组,HSP72的表达水平明显增高,且存活率较高。结论:HSP72的基因水平检测可以作为判断重症患者预后的客观指标。
OBJECTIVE: To study the expression of heat shock protein 72 (HSP72) gene and the prognosis of early stage of stress in diabetic and non-diabetic acute trauma patients. Methods: Thirty-eight patients with A-PACHEIll score ≥18 were randomly selected and divided into diabetic group and non-diabetic group. Neutrophils were isolated from 0 to 1 day, 2 to 6 days and 7 to 14 days after injury RT-PCR was used to detect the content of HSP72mRNA. The changes between groups were compared. The survival rate of 2 months was recorded and the relationship between the HSP72mRNA and prognosis was studied. Results: The expression of HSP72 was significantly increased after acute stress, with a peak in 2 ~ 6 days. The expression of HSP72 in non-diabetic patients was significantly higher than that in diabetic patients, and the survival rate was higher. Conclusion: The detection of HSP72 gene level can be used as an objective index to judge the prognosis of critically ill patients.