热休克蛋白70在大鼠严重创伤后早期肝损伤中的变化及其意义

目的 探讨严重创伤后早期热休克蛋白70(heat schock protein,HSP70)在肝组织中的表达变化，及其在肝脏继发性损伤中的作用。方法 成年雄性Wistar大鼠176只，采用严重胸部撞击伤伴单侧股骨骨折模型。动态观察创伤后24h大鼠肝组织HSP70、肝脏病理、血清肝功能生化指标等变化。结果 HSP70在肝组织中表达伤后迅速增加，8h达到峰值，24h仍维持在较高水平。但肝脏病理、血清ALT及TB的改变无显著差异。使用Ru486阻断糖皮质激素受体再致伤后，肝组织HSP70表达较单纯创伤组明显增多；肝窦内有较多炎性细胞浸润；血清ALT及TB在伤后早期即有明显升高。结论 HSP70可能参与了肝组织细胞抗损伤机制的启动，但HSP70过高表达，则可能对肮脏造成损害。HSP70可较好反映创伤后肝损伤与抗损伤这一病理生理过程。

Changes and signficance of HSP70 in liver with secondary hepatic injury in the early stage in rats after severe trauma

Objective To investigate the changes of heat shock protein(HSP70)in rat hepatic tissue in early stage after severe trauma,as well as function after secondary liver injury.Methods 176 adult male Wistar rats were randomly divided into control,severe trauma,severe trauma with 50% glucocorticoid receptors (GR) blocked group(STBG1),severe trauma with 80% GR blocked group(STBG2).Rat model was produced by using severe thoracic impact injury associated with single femur fracture.Dynamic changes of rat hepatic tissue HSP70,pathology of liver.hepatic function markers in serum after severe trauma were examined.Results HSP70 gradually increased in hepatic tissue after severe trauma,reaching the highest at 8h after trauma,and maintained at rather high level 24h after trauma.But alterations of hepatic pathology,ALT and TB in serum were not obvious after trauma.After usage of GR blocking agent,HSP70 production was much higher than simple trauma group.There were many inflammatory cells infiltrating the hepatic sinusoids.Increases in plasma ALT and TB were obvious in the early stage after trauma.Conclusion HSP 70 may be involved in starting the anti injury mechanism of hepatic tissue.But excessive expression of HSP70 may cause injury to liver after severe trauma.HSP70 can reflect pathophysiological course of hepatic tissue injury after severe trauma.