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HSP70和CX43水平与急性心肌梗死并发应激性溃疡相关性研究
作者:钟海洋1  罗杰鸿1  林杰忠1  张创良2 
单位:1. 惠州中心人民医院 心血管内科, 广东 惠州 516000;
2. 海南省干部疗养院 重症医学科, 海南 海口 571100
关键词:急性心肌梗死 应激性溃疡 热休克蛋白70 间隙连接蛋白43 
分类号:R542.2+2
出版年·卷·期(页码):2020·39·第二期(217-221)
摘要:

目的: 探讨热休克蛋白70(HSP70)和细胞间隙连接蛋白43(CX43)与急性心肌梗死(AMI)并发应激性溃疡(SU)的相关性。方法: 选取2017年6月至12月于××医院诊断为AMI患者120例,根据Killip分级分为4组(KillipⅠ组、KillipⅡ组、KillipⅢ组、KillipⅣ组),各组入院24 h内采集外周静脉血,ELISA法检测各组血清HSP70和CX43水平,并计算各组血红蛋白(Hb)下降情况(入院第1天Hb-入院第14天Hb)。根据有无并发SU分为AMI组和AMI+SU组,分析各组HSP70、CX43水平和Hb下降情况,并探讨HSP70和CX43与血红蛋白下降相关性。结果: 根据Killip分级,4组HSP70、CX43水平分别为Ⅰ组63±4.182 pg·mL-1、107±3.63 pg·mL-1,Ⅱ组69±3.19 pg·mL-1、111±5.63 pg·mL-1,Ⅲ组65±2.61 pg·mL-1、105±4.09 pg·mL-1,Ⅳ组67±4.09 pg·mL-1、115±5.63 pg·mL-1,各组之间差异无统计学意义(P>0.05);各组Hb下降水平分别为5.4±0.9 g·L-1、7.6±0.8 g·L-1、6.4±0.5 g·L-1、5.9±0.4 g·L-1,各组之间差异无统计学意义(P>0.05)。根据有无SU发生分组后,AMI+SU组血清HSP70(76±2.14 pg·mL-1)和CX43(145±4.63 pg·mL-1)水平显著高于AMI组(54±3.69 pg·mL-1;89±6.26 pg·mL-1),差异具有统计学意义(P<0.05);AMI+SU组Hb下降水平(17±2.1 g·L-1)高于AMI组(7±1.1 g·L-1),差异具有统计学意义(P<0.05);同时两者与血红蛋白下降水平显著负相关关系(P<0.05)。结论: HSP70和CX43与AMI严重程度无相关性,但与AMI并发SU的息息相关,可预测SU的发生。

Objective: To study the relation between heat shock protein 70 (HSP70), connexin 43 (CX43) and stress ulceration (SU) induced by acute myocardial infarction (AMI). Method: 120 patients with AMI were recruited from Jun 2017 to Dec 2017, and blood samples were obtained in the first 24 hours after patients arrived hospital. They were divided into four groups (KillipⅠ, KillipⅡ, KillipⅢ, KillipⅣ) according to Killip classification. HSP70 and CX43 were detected by ELISA, and hemoglobin reduction levels were analyzed in each groups. Also, the patients were divided into two groups (AMI group and AMI+SU group) according whether occured in SU. The HSP70 and CX43 levels and Hb reduction levels were analyzed. The relation between HSP70, CX43 and Hb reduction levels were analyzed. Result: In the four groups, the levels of HSP70 andCX43 were (Ⅰ:63±4.182 pg·mL-1, 107±3.63 pg·mL-1; Ⅱ:69±3.19 pg·mL-1, 111±5.63 pg·mL-1; Ⅲ:65±2.61 pg·mL-1, 105±4.09 pg·mL-1; Ⅳ:67±4.09 pg·mL-1, 1115±5.63 pg·mL-1), there were no statistically significant difference between the groups (P>0.05). Besides, the Hb reduction levels were (5.4±0.9 g·L-1, 7.6±0.8 g·L-1, 6.4±0.5 g·L-1, 5.9±0.4 g·L-1), there were no statistically significant difference between the groups (P>0.05). In the two groups, compared with the AMI group, the levels of HSP70 (76±2.14 pg·mL-1) and CX43 (145±4.63 pg·mL-1) in AMI+SU group were significantly increased (P<0.05); the hemoglobin reduction levels in AMI+SU group (17±2.1 g·L-1) were significantly higher than AMI group (7±1.1 g·L-1) (P<0.05). Besides, HSP70 and CX43 have a negative correlation with SU induced by AMI (P<0.05).Conclusion: HSP70 and CX43 have nocorrelation with AMI severity, but have correlated with AMI concurrent SU and could predict SU occurrence.

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