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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。
Objective To study the changes of heat shock protein 70 (HSP70) and its antibodies in peripheral blood lymphocytes in elderly patients with cerebral infarction and its relationship with severity, infarction location and prognosis. Methods According to the score of clinical neurological deficit in patients with stroke, 65 patients with cerebral infarction over 60 years of age were divided into three groups: mild, moderate and severe cerebral infarction. 34 healthy controls were selected as control group. The expression of HSP70 in peripheral blood lymphocytes was detected by Western Blot with immobilized protein. The antibody titer of HSP70 in plasma was detected by enzyme-linked immunosorbent assay (ELISA). Results Within 24 hours after onset, the expression of HSP70 in mild, moderate and severe cerebral infarction group were 708.67 ± 193.56, 585.95 ± 165.39 and 421.18 ± 123.87, respectively. Compared with the control group, the expression of HSP70 was 86.08 ± 34.13 (P <0.05). The positive rate of antibody of middle cerebral artery and severe cerebral infarction was higher than that of healthy control group (P <0.05), the positive rate of antibody of severe cerebral infarction was also higher than that of mild cerebral infarction (P <0.05) (P <0.01). The positive rate of antibody and the titer of antibody decreased gradually with the prolongation of the course of disease (P < 0.05). The location of cerebral infarction had no correlation with the expression level of HSP70 and the positive rate of its antibody (P <0.05). Conclusion The determination of HSP70 expression level and antibody titer within 24 hours after onset in senile patients with cerebral infarction can be used as one of the objective and quantitative indicators to diagnose cerebral infarction in early clinical stage, estimate the severity of illness and judge the prognosis of patients.