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目的探讨热休克蛋白70在急性肾损伤的临床价值。方法选用住院新发急性肾损伤患者为对象,以健康人为对照。动态观察检测急性肾损伤患者AKI1期、AKI2期、AKI3期及对照组,使用ELISA检血HSP70、尿HSP70、血TNF-α、血IL-1等因子,应用BeckmanDUC28型自动生化分析仪测定血清BUN、Cr。结果 AKI患者各期血HSP70、尿HSP70、血BUN、血CR显著性高于对照组(P<0.05),AKI3期血HSP70、尿HSP70、血BUN、血CR高于AKI1期比较有统计学意义(P<0.05)。AKI患者各期TNF-α、IL-1显著性高于对照组(P<0.05)。AKI3期血TNF-α、IL-1浓度低于AKI1期比较有统计学意义(P<0.05)。急性肾损伤中血HSP70与血BUN、血CR、尿HSP70呈正相关(r=0.826,P<0.05;r=0.923,P<0.05;r=0.872,P<0.05),与TNF-α、IL-1炎性因子呈负相关(r=-0.927,P<0.05r=-0.783,P<0.05)。结论急性肾损伤HSP70表达增多反映肾损伤的严重程度,同时HSP70表达可能抑制炎症因子的的激活,启动了内源性保护机制,利于肾脏损伤的修复。
Objective To investigate the clinical value of heat shock protein 70 in acute renal injury. Methods The hospitalized patients with acute renal injury were selected as subjects and healthy people as control. The dynamic changes of AKI1, AKI2, AKI3 and control group were detected by dynamic observation. Serum BUN was measured by BeckmanDUC28 automatic biochemical analyzer using ELISA for blood serum HSP70, urine HSP70, blood TNF-α and blood IL-1, , Cr. Results The serum HSP70, urinary HSP70, blood BUN and blood CR in all stages of AKI patients were significantly higher than those in the control group (P <0.05). There was significant difference in the serum levels of HSP70, HSP70, BUN, and blood CR between AKI3 and AKI1 (P <0.05). The levels of TNF-α and IL-1 in AKI patients were significantly higher than those in control group (P <0.05). The levels of TNF-α and IL-1 in AKI3 stage were lower than those in AKI1 stage (P <0.05). There was a positive correlation between serum HSP70 and blood BUN, blood CR and urine HSP70 in acute renal injury (r = 0.826, P <0.05; r = 0.923, P < 1 inflammatory factor was negatively correlated (r = -0.927, P <0.05r = -0.783, P <0.05). Conclusion The increased expression of HSP70 in acute kidney injury can reflect the severity of renal injury. At the same time, the expression of HSP70 may inhibit the activation of inflammatory cytokines and initiate the endogenous protective mechanism, which is beneficial to the repair of renal injury.