原发免疫性血小板减少症患者外周血单个核细胞热休克蛋白90的表达及与激素疗效相关性分析  

Expression of heat shock protein 90 in adult patients with primary immune thrombocytopenia and correlations with glucocorticoid resistance

作　　者：马亮亮[1] 梁燕[1] 方美云[1] 贾治林[1] 司阳[1] 关艳春[1] 王雪娜[1] 

机构地区：[1]大连医科大学附属第一医院血液科,辽宁省116011

出　　处：《中华临床医师杂志（电子版）》2012年第6期14-17,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：卫生行业科研专项项目(200802031);中国医师协会血液分会课题(20100136);大连市科委科技计划(2009E12SF166)

摘　　要：目的探讨原发免疫性血小板减少症(ITP)患者糖皮质激素受体分子伴侣——热休克蛋白90(HSP90)表达特点及与激素疗效、部分临床指标的相关性。方法采用实时荧光定量PCR方法检测44例初发ITP患者外周血单个核细胞(PBMC)的HSP90 mRNA,同时检测32例正常人作为对照。将ITP患者按糖皮质激素(GC)治疗效应分为GC敏感组和GC抵抗组,再按年龄、性别、病程和病情进行分组比较,同时分析患者HSP90 mRNA与血小板数、骨髓巨核细胞数及血小板抗体IgG的相关性。结果 44例ITP患者外周血PBMC的HSP90 mRNA中位数为0.90(0.48～2.52),32例正常人为1.40(0.82～2.65),正常人较ITP患者HSP90 mRNA有升高趋势,但两组无统计学差异(P>0.05)。成人急性ITP患者HSP90 mRNA表达显著高于慢性患者(P<0.05)。GC敏感组HSP90 mRNA表达中位数高于抵抗组,但两组无统计学差异(P>0.05)。再按性别、年龄和病情分组比较,可见年龄≤60岁较年龄>60岁患者,轻型较重型患者,HSP90 mRNA均有升高趋势,但亦无统计学差异(P>0.05)。ITP患者HSP90 mRNA水平与血小板数、骨髓巨核细胞数及血小板抗体IgG无明显相关性。结论 HSP90 mRNA在急性ITP患者显著高于慢性患者,显示与病程密切相关,结合其在GC敏感组较抵抗组表达升高的趋势,推测其在ITP中表达下调与GC抵抗有关联。Objective To investigate the expression of HSP90 in primary immune thrombocytopenia（ITP） patients and correlations with glucocorticoid resistance.Methods HSP90 mRNA was tested by real time PCR assay in forty-four newly diagnosed ITP patients and thirty-two healthy volunteers.Then patients with ITP were divided into several subgroups according to glucocorticoid response,gender,age,stage and severity of disease,and analyzed difference of each pair of subgroups.Platelet associated IgG（PAIgG）was measured by a competitive enzyme immunoassay（ELISA）.Results No significant difference was found in expression of HSP90 mRNA between ITP patients and healthy volunteers（P0.05）,whereas the level of HSP90 expression tended to be lower in ITP patients.The level of HSP90 expression was significantly higher in acute patients than chronic patients（P0.05）.There was no significant difference between GC sensitive and GC resistant patients,between female and male patients,between younger and older patients,and between mild and severe patients.However,the frontier in each pair tended to be higher than latter subgroup.No significant correlation between HSP90 mRNA and number of platelets or megakaryocytes or PAIgG was found in ITP patients.Conclusions HSP90 mRNA was related with the stage of diseases in ITP.A decreased expression of HSP90 might play a role in GC resistance of ITP.

关 键 词：血小板减少症 HSP90热休克蛋白质类 糖皮质激素类 

分 类 号：R558[医药卫生—血液循环系统疾病]