关键词:

热休克蛋白70, 热休克蛋白90, 胃泌素, 重症颅脑损伤, 应激性溃疡

Abstract:

Objective To explore the predictive value of serum heat shock protein 70（HSP70），heat shock protein 90（HSP90）and gastrin（GAS）level in severe craniocerebral injury complicated with stress ulcer. Methods A total of 126 patients with severe craniocerebral injury were selected. Serum level of HSP70，HSP90 and GAS were detected by enzyme⁃linked immunosorbent assay（ELISA）after admission，and standard decompres⁃ sive craniectomy combined with lumbar cistern drainage was performed. The incidence of stress ulcer was analyzed， and the relationship of serum HSP70，HSP90 and GAS level with stress ulcer and the predictive effect of HSP70， HSP90 and GAS level were analyzed. Results The incidence of stress ulcer was 32.17% . The level of serum HSP70，HSP90 and GAS in patients with stress ulcer were higher than that in patients without stress ulcer（P < 0.05）. Age，GCS of 3⁃5 at admission，serum HSP70，HSP90 and GAS level，TRF level，and random blood glucose level after admission，hypotension，hypoxemia，metabolic acidosis and application of glucocorticoid were risk factors of stress ulcer（P < 0.05），while Hb level after admission，HCT after admission，application of gastric mucosal protective drugs and ulinastatin were the protective factors（P < 0.05）. The sensitivity of combination of serum HSP70，HSP90 and GAS level in predicting severe craniocerebral injury complicated with stress ulcer was higher than that of each single index（P < 0.01），and AUC was larger than that of single index prediction（P < 0.05）. There was no significant difference in specificity between the combination and single prediction（P > 0.05）. Conclusion The increase of serum HSP70，HSP90 and GAS level can increase the risk of stress ulcer in severe brain injury. Age，and GCS of 3⁃5 at admission are the risk factors as well，while Hb level and HCT after admission are the protec⁃ tive factors. The combined prediction of HSP70，HSP90 and GAS level is highly effective for predicting stress ulcer.

Key words:

heat shock protein 70, heat shock protein 90, gastrin, severe brain injury, stress ulcer