替普瑞酮诱导HSP60、70高水平表达后对严重烧伤患者急性胃黏膜损伤保护作用的研究

发布时间：2018-06-01 07:56

本文选题：烧伤 + 替普瑞酮　；参考：《南昌大学》2013年硕士论文

【摘要】：目的：通过预防性应用HSPs诱导剂替普瑞酮及胃镜动态观察严重烧伤患者胃黏膜损伤情况，同时检测热休克70基因及热休克蛋白60、70的表达变化，探讨HSPs诱导剂替普瑞酮对严重烧伤患者胃黏膜的保护作用及HSP60、70保护胃黏膜的可能机制。方法：将严重烧伤患者分为替普瑞酮治疗组、常规治疗组及正常对照组，其中替普瑞酮及常规治疗组每组15人，正常对照组为10人。于入院第1周及第4周通过行胃镜检查及进行胃黏膜标本采集，采用免疫组化方法检测胃黏膜HSP60、HSP70的表达；采用Realtime-PCR方法检测胃黏膜组织内HSP72mRNA的表达。结果：1.胃镜检查及HE染色结果显示替普瑞酮治疗组胃黏膜损伤程度比常规治疗组胃黏膜损伤程度明显减轻。2.免疫组化检测结果显示：替普瑞酮治疗组中患者伤后第1周内的HSP60表达水平（0.1427±0.0149）明显高于常规治疗组患者伤后第1周内的表达水平（0.1122±0.0118）及正常对照组的表达水平(0.0406±0.0037),差异有统计学意义（P0.05）；替普瑞酮治疗组患者伤后第4周的HSP60表达水平（0.0468±0.0051）略高于常规治疗组患者伤后第4周的表达水平（0.0433±0.0045）及正常对照组的表达水平(0.0406±0.0037),差异无统计学意义（P0.05）。替普瑞酮治疗组中患者伤后第1周内的HSP70表达水平（0.1587±0.0162）明显高于常规治疗组患者在伤后第1周内表达水平（0.1281±0.0131）及正常对照组的表达水平(0.0402±0.0038),差异有统计学意义（P0.05）；替普瑞酮治疗组中患者伤后第4周的HSP70表达水平（0.047±0.0048）略高于常规治疗组患者伤后第4周的表达水平（0.0439±0.0044）及正常对照组的表达水平(0.0402±0.0038),差异无统计学意义（P0.05）。3.Real-time PCR检测结果显示：替普瑞酮治疗组中患者在伤后第1周的HSP72mRNA表达水平（1.002±0.061）明显高于常规治疗组患者在伤后第1周的表达水平（0.797±0.049）及正常对照组的表达水平（0.312±0.033），差异有统计学意义（P0.05）；替普瑞酮治疗组中患者在伤后第4周的HSP72mRNA表达水平（0.355±0.028）略高于常规治疗组中患者在伤后第4周的表达水平（0.338±0.024）及正常对照组的表达水平（0.312±0.033），差异无统计学意义（P0.05）。结论：替普瑞酮治疗组的重度烧伤患者通过预防性的应用HSPs诱导剂替普瑞酮后胃黏膜内HSP60、HSP70的表达均比常规治疗组增加，，而其胃黏膜应激性溃疡的严重程度比常规治疗组要明显减轻，这说明HSPs诱导剂替普瑞酮在诱导HSP60、70高表达后确实能对大面积烧伤后应激性溃疡产生防护作用，这为替普瑞酮在临床上作为胃黏膜保护剂防治应激性溃疡提供了重要的依据.
[Abstract]:Objective: to observe the gastric mucosal injury in patients with severe burn by prophylactic application of HSPs inducer tipranone and gastroscope, and to detect the expression of heat shock 70 gene and heat shock protein 6070. To investigate the protective effect of HSPs inducer tipranone on gastric mucosa in severely burned patients and the possible mechanism of HSP60P70 in protecting gastric mucosa. Methods: severe burn patients were divided into three groups: tipranone treatment group, routine treatment group and normal control group. There were 15 patients in each group in tipranone group and 10 in normal control group. The expression of HSP60 and HSP70 in gastric mucosa and HSP72mRNA in gastric mucosa were detected by immunohistochemical method and Realtime-PCR method respectively at the 1st and 4th week after admission. The result is 1: 1. The results of endoscopy and HE staining showed that the degree of gastric mucosal damage in tipranone treatment group was significantly less than that in routine treatment group. The results of immunohistochemistry showed that the expression level of HSP60 in the tipranone treatment group was 0.1427 卤0.0149 in the first week after injury, which was significantly higher than that in the routine treatment group (0.1122 卤0.0118) and the normal control group (0.0406 卤0.0037). The expression level of HSP60 in the treatment group was 0.0468 卤0.0051 at the 4th week after injury, which was slightly higher than that in the routine treatment group (0.0433 卤0.0045) and the normal control group (0.0406 卤0.0037). There was no significant difference between the two groups (P 0.05). The expression level of HSP70 in tipranone treatment group was 0.1587 卤0.0162) significantly higher than that in routine treatment group (0.1281 卤0.0131) and normal control group (0.0402 卤0.0038), the difference was statistically significant (P 0.05). The expression level of HSP70 in ketone treatment group was 0.047 卤0.0048 at the 4th week after injury, which was slightly higher than that in routine treatment group (0.0439 卤0.0044) and normal control group (0.0402 卤0.0038). The expression level of HSP72mRNA in the propranone treatment group was significantly higher than that in the routine treatment group at the 1st week after injury (1.002 卤0.061) and in the normal control group (0.312 卤0.033), the difference was statistically significant (P 0.05), and that of tipranone was significantly higher than that in the routine treatment group (0.797 卤0.049) and the normal control group (0.312 卤0.033). The expression level of HSP72mRNA in the treatment group was 0.355 卤0.028 at the 4th week after injury, which was slightly higher than that in the routine treatment group (0.338 卤0.024) and the normal control group (0.312 卤0.033). There was no significant difference between the two groups (P 0.05). Conclusion: the expression of HSP60 + HSP70 in gastric mucosa of severe burn patients in tipranone group was significantly higher than that in routine treatment group. The severity of stress ulcer of gastric mucosa was significantly reduced in its gastric mucosa than that in the routine treatment group, which indicated that tipranone, the inducer of HSPs, could protect the stress ulcer after extensive burn by inducing the high expression of HSP60M70. This provides an important basis for the prevention and treatment of stress ulcer by tipranone as a gastric mucosal protector.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R644;R573

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