【摘要】 目的研究老年脑梗死患者外周血淋巴细胞热休克蛋白70(HSP70)及其抗体的变化规律、变化程度及与病情轻重、梗死部位、预后的关系。方法按《脑卒中患者临床神经功能缺损程度评分标准》将65例60岁以上老年脑梗死患者分为轻型、中型及重型脑梗死三组;选择34例健康老年人作为对照组。应用固定化蛋白质的免疫学测定(Western Blot)法测定其外周血淋巴细胞中 HSP70表达水平;用酶联免疫吸附法(ELISA)检测其血浆 HSP70抗体滴度。结果在发病后24h 内,轻型、中型及重型脑梗死组 HSP70表达水平分别为708.67±193.56、585.95±165.39及421.18±123.87积分光密度,各组之间比较及其与健康对照组的86.08±34.13积分光密度比较差异有显著性(P<0.05);中、重型脑梗死抗体阳性率高于健康对照组(P<0.05)、重型脑梗死抗体阳性率也高于轻型脑梗死(P<0.05);随病程延长,HSP70表达水平逐渐下降,轻型脑梗死组下降幅度较大而重型梗死组下降幅度较小(P<0.01),抗体阳性率及滴度比例也随病程的延长逐渐下降(P<0.05)。脑梗死的部位与 HSP70表达水平及其抗体阳性率无相关关系(P<0.05)。结论测定老年脑梗死患者起病后24小时内 HSP70表达水平及其抗体滴度,可作为临床早期诊断脑梗死、估计病情轻重、判断患者预后的客观、量化指标之一。更多还原

【Abstract】 Objective To investigate the changes of heat shock protein 70(HSP70)and its antibody in peripheral blood lymphocytes in patients with cerebral infarction(CI)and the correlation between HSP70 and severity or location of CI as well as in healthy middle age and old people and the correlation between HSP70 and sex and/or age.Methods The subjects studied were divided into a group of cerebral infarction and a group of healthy middle age and old people.The former consisted of 92 patients with CI aged 60 years and old- er.According to a scoring criteria of neurological function defect in patients with stroke.They were divided in- to mild,Moderate and severe subgroups.The latter consisted of 102 healthy middle age and old people(52 males and 50 females).They were divided into 4 subgroups according to age by decades.Healthy subjects with age older than 60 years served as a control group for CI.Express levels of HSP70 in peripheral blood lym- phocytes were measured with Western blot method and titer value of antibody in plasma was determined with ELISA method.Results 1.Within 24 hours of onset of CI,express levels of HSP70 in mild CI,moderate CI,severe CI and the control group were(708.67±193.56),(585.95±165.39),(421.18±123.87)and (86.08±34.13)imegrals in photo-densitomerry respectively.The highest express in milder CI group,and the lowest level in the more severe group were significantly different among the subgroups(P<0.05).the pos- itive rate of the antibody of HSP70 was highest in this period,being 11.96%.Express levels of HSP70 de- creased gradually during the course of cerebral infarction.The amplitude decrease of HSP70 in the milder CI group was greater than that in the more severe CI group(P<0.01).The positive rate and titer value of anti- body reduced also gradually during the course of the disease(P<0.05).There was no significant correlation between infract location and express levels of HSP70 or titer value of antibody(P>0.05).2.Analysis of HSP70 in peripheral blood lymphocytes in healthy middle age,and old people showed that age was negatively correlated with HSP70 level(P<0.05).The express levels of HSP70 reduced gradually in healthy middle age and old people along with aging and the positive rate of the antibody of HSP70 was 1.96%.There was no significant correlation among the 4 subgroups(P>0.05)according to age by decades.Conclusions Measure- ment of express levels of HSP70 and its titer value of antibody 24hours after the onset of cerebral infarction could be used as an objective and quantitative index for early detection and prediction of the severity and prog- nosis of CI.Express levels of HSP70 and its titer value of antibody could also be used to appraise the stress ability and the health state of healthy middle age and old people.更多还原