热休克蛋白70抗体检测在听神经病患者中的临床意义  

Clinical implications of the heat shock protein 70 antibody for identifying auditory neuropathy patients

作　　者：兰兰[1] 郭维[1] 赵亚丽[1] 赵阳[1] 顾瑞[1] 王秋菊[1] 

机构地区：[1]中国人民解放军总医院耳鼻咽喉-头颈外科解放军耳鼻咽喉科研究所,北京100853

出　　处：《中华耳科学杂志》2010年第2期167-170,共4页Chinese Journal of Otology

基　　金：国家自然基金重点项目(30830104);国家自然基金面上项目(30672310&30771203);北京市自然科学基金重大项目(7070002);国家"十一五"科技支撑计划(2006BAI02B06&2007BAI18B12)联合资助

摘　　要：目的进行基于蛋白质表达水平的热休克蛋白70(heat shock protein,HSP70)抗体在临床诊断听神经病患者中的临床指导意义研究。探讨HSP70作为听神经病诊断的可靠应激标志物及判断预后前瞻性标记物的可行性分析。方法对92例受试者的新鲜血清液进行了HSP70抗体检测。92例受试者为门诊就诊的患者和正常对照组。其中包括18例诊断为听神经病患者、23例听力正常的听神经病患者亲属、19例听力正常无血缘关系的正常对照、32例感音神经性耳聋患者。所有患者均进行纯音测听、听性脑干反映潜伏期、鼓室声导纳测试、耳声发射检查,部分患者接受了核磁共振及颞骨CT扫描检查。HSP70的表达研究应用的是免疫印迹法检测受试者血清HSP70抗体反应,采用美国IMMCO公司的Otoblot抗68kDa(HSP70)免疫印迹诊断试剂盒进行检测,抗HSP70抗体阳性的反应在68kDa处出现蓝紫色条带。结果应用stata7.0进行统计分析68kDa蛋白阳性表达情况,显示在听神经病组和其家属组之间比较无差异(卡方检验P=0.43>0.05);听神经病组和感音神经性聋组间比较也无差异(卡方检验P=0.98>0.05)。但是听神经病组和正常组比较,两组间有差异(Fisher,P=0.02<0.05);听神经病亲属组和正常组比较,两组间没有差异(卡方检验,P=0.11>0.05);感音神经性聋和正常组比较,两组间有差异(卡方检验,P=0.018<0.05)。结论综合以上结果 ,我们认为抗68kDa抗体的免疫印迹检测对听神经病的诊断特异性和敏感性不理想,尚不能作为临床上的应激标记物和预后判断的指标。Objective To explore the clinical implications of the protein expression of the heat shock protein 70 （heat shock protein, HSP70） antibody to be used to diagnose auditory neuropathy （auditory neuropathy, AN） in clinic settings. To analyze the feasibility of HSP70 as a reliable stress-marker as well as its utility as an early prognosis marker. Methods Fresh blood serum from 92 subjects was given HSP70 antibody test, and these participants were either the patients enrolled at 301 Hospital or healthy individuals, further classified into 18 AN patients, 23 normal hearing family numbers of these AN patients, 19 independent normal hearing individuals, and 32 patients affected with sensorineural hearing loss. All of the subjects received several audiological tests including pure tone audiometry, auditory brain stem response, aural acoustic impedance, and distortion product otoacoustic emission. Part of the patients received MRI and CT exam on temporal bone. Western blot was used to measure the HSP70 antibody response in the blood serum of the subjects using Otoblot antibody 68kDa（hsp-70） provided by USA IMMCO Co. Positive reaction was identified by a violet band. Results Stata 7.0 software was used to analyze the expression of the 68kDa protein, and the results indicated that there was no significant differences between AN patients and their hearing normal family members （Chi-square test, P =0.425 0.05）, or between AN patients and patients with sensorineural hearing loss （Chi-square test, P = 0.979 0.05）. Nevertheless, there was a significant difference between AN patients and normal hearing subjects （Fisher Exact test, P = 0.020.05）. There was no significant difference between the family numbers of AN patients and normal hearing persons （Fisher Exact test, P = 0.114 0.05）. Finally, between the patients with sensorineural hearing loss and normal hearing persons, there was a significant difference （Chi-square test, P = 0.018 0.05）. Conclusion In conclusion, this study showed that clinical

关 键 词：听神经病 热休克蛋白70 68kDa蛋白 听力损失 

分 类 号：R764.4[医药卫生—耳鼻咽喉科] R349.5[医药卫生—临床医学]