维持性血液透析患者炎症状态与血清热休克蛋白70的关系

目的探讨维持性血液透析（MHD）患者热休克蛋白70（HSP70）检测与炎症状态的关系。方法将MHD患者92例根据超敏C反应蛋白（hs-CRP）水平分为2组：非炎症组（hs-CRP〈3mg／L）58例；炎症组（hs-CRP≥3mg／L）34例。检测2组患者血清前白蛋白（PA）、血白蛋白（Alb）、hs-CRP、血红蛋白（Hb）、HSP70、铁蛋白、肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）等。结果尿毒症患者血清HSP70与hs-CRP、IL-6、TNF-α、铁蛋白等炎症指标无明显相关性；与Hb、Alb、总胆固醇等营养指标也无相关性。非炎症组透析前HSP70水平较低，透析后迅速升高（P=0．013）；而炎症组透析前后的HSP70水平差异无统计学意义（P=0．871）。结论炎症状态可能是导致炎症组HSP70升高的原因；但HSP70不能反映MHD患者是否存在慢性炎症状况，也不能反映其蛋白质营养状态。透析前、后HSP70水平检测可反映机体抗应激反应能力。

Relationship between serum levels of heat shock protein 70 and inflammatory state in maintenance hemodialysis patients

Objective To explore the relationship between heat shock protein 70 and inflamma- tory state in maintenance hemodialysis patients. Methods 92 maintenance hemodialysis patients were divided into two groups by hs-CRP levels：Non-inflammatory group（hs-CRP〉3 mg/L）was 58 cases, inflammation group（hs-CRP≥3 mg/L）was 34 cases. The detection indicators were serum prealbumin, albumin （Alb）,high-sensitivity C-reactive protein （hs-CRP）, hemoglobin（Hb）, heat shock protein 70 （HSP70）, tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6）. Results Serum HSP70 showed no significant relevance with inflammation indicators such as hs-CRP, IL-6, TNF-α, or ferritin. There was no correlation with nutrition indicators including Hb, Alb, T-chol either. The inflammation group had higher levels of HSP70, However, it had no significant difference before and after hemodialysis（P = 0. 871 ）. In the non-inflammatory group the serum level of HSP70 were lower ,but increased rapidly af- ter hemodialysis（P = 0. 013）. Conclusions Inflammatory state may lead to elevating of HSP70. HSP70 can not reflect the chronic inflammatory condition or protein nutritional status of the MHD patients. The HSP70 level detection before and after dialysis may reflect the body＇s anti-stress reaction ability.