热休克蛋白70在胆道闭锁肝组织纤维化中作用及对预后影响

发布时间：2018-11-26 17:27

【摘要】：目的探讨热休克蛋白70在胆道闭锁(BA)肝组织纤维化中的作用及对预后的影响。方法选取择期行Kasai术治疗的BA患儿46例、胆总管囊肿患儿30例和门静脉海绵样变患儿17例;免疫组化染色检测肝组织中HSP 70蛋白表达,利用天狼星红-饱和苦味酸染色液检测BA患儿肝组织纤维化,双重染色法检测BA患儿不同纤维化肝组织中HSP 70蛋白表达,所有BA患儿术后均获得随访。结果 BA、胆总管囊肿以及静脉海绵样变患儿三组,HSP 70蛋白高表达比例的差异有统计学意义(χ~2=7.99,P=0.018),以BA组的HSP 70蛋白高表达比例为最高。等级相关分析显示,肝组织中HSP70蛋白表达强度与肝纤维化程度呈正相关(r=0.861,P0.001);46例BA患儿中,死亡15例,生存分析显示,轻度BA患儿术后生存率82.4%,中位生存时间(34.6±2.3)月;中重度患儿术后生存率58.6%,中位生存时间(25.5±2.8)月;Log-Rank检验显示,两组生存函数的差异有统计学意义(χ~2=5.27,P=0.012)。BA患儿中,HSP 70蛋白低表达者的生存率85.0%,术后中位生存时间(34.0±2.6)月,HSP70蛋白高表达者生存率53.8%,术后中位生存时间(18.3±2.2)月;Log-Rank检验显示,两组生存函数差异有统计学意义(χ~2=4.77,P=0.029)。结论 BA患儿肝组织中HSP70蛋白呈高表达,且与肝组织纤维化程度呈正相关,推测其可能参与了肝纤维化进程,HSP70表达上调往往预示患儿预后不良。
[Abstract]:Objective to investigate the role of heat shock protein 70 (HSP70) in hepatic fibrosis of biliary atresia (BA) and its influence on prognosis. Methods 46 cases of BA, 30 cases of choledochal cyst and 17 cases of portal cavernous degeneration were selected. Immunohistochemical staining was used to detect the expression of HSP 70 protein in liver tissue, Sirius red saturated picric acid staining solution was used to detect liver fibrosis in children with BA, and double staining method was used to detect the expression of HSP 70 protein in different fibrosis liver tissues of BA children. All children with BA were followed up after operation. Results the high expression ratio of HSP 70 protein in BA, choledochal cyst and cavernous venous degeneration group was significantly higher than that in BA group (蠂 ~ 2 = 7.99). The highest expression rate of HSP 70 protein was found in BA group. Grade correlation analysis showed that there was a positive correlation between the expression of HSP70 protein and the degree of hepatic fibrosis. Survival analysis showed that the survival rate of mild BA patients was 82.4 months and the median survival time was (34.6 卤2.3) months. The survival rate was 58.6 months and the median survival time was (25.5 卤2.8) months. Log-Rank test showed that there was a significant difference in survival function between the two groups (蠂 ~ 25.27 / 0. 012). BA). The survival rate of patients with low expression of HSP 70 protein was 85.0 and the median survival time was (34. 0 卤2. 6) months. The survival rate of the patients with high expression of HSP70 protein was 53.8% and the median survival time was (18.3 卤2.2) months. Log-Rank test showed that the difference of survival function between the two groups was statistically significant (蠂 ~ 2 ~ (4.77) P ~ (0.029). Conclusion there is a high expression of HSP70 protein in liver tissue of children with BA, and it is positively correlated with the degree of hepatic fibrosis. It is speculated that it may participate in the process of hepatic fibrosis, and the up-regulation of HSP70 expression may predict the poor prognosis of the children.
【作者单位】：郑州市儿童医院小儿外科;
【分类号】：R725.7

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