热休克蛋白70在儿童噬血细胞性淋巴组织细胞增生症血清中的表达及其临床意义  

Expression and Clinical Significance of Heat Shock Protein 70 in Serum of Hemophagocytic Lymphohistiocytosis in Children

作　　者：卢文婕 王卓 杨李 龙飞 陈晶佩 孙鸣 王伟[1] 张兰男 许秀文 熊昊[2] LU Wenjie;WANG Zhuo;YANG Li;LONG Fei;CHEN Jingpei;SUN Ming;WANG Wei;ZHANG Lannan;XU Xiuwen;XIONG Hao(Department of Hematology,Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan Hubei 430010,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院儿童血液科,湖北武汉430010 [2]华中科技大学同济医学院附属武汉儿童医院血液科,湖北武汉430010

出　　处：《联勤军事医学》2024年第12期1047-1050,1054,共5页Military Medicine of Joint Logistics

基　　金：武汉市医学科研项目(WX21D60)。

摘　　要：目的 探究热休克蛋白70(heat shock protein 70,HSP70)在儿童噬血细胞性淋巴组织细胞增生症(hemophagocytic lymphohistiocytosis, HLH)血清中的表达情况及临床意义。方法 以2019-09/2021-08月作者医院诊断的HLH患儿为HLH组(n=12),脓毒血症患儿为脓毒血症组(n=45),健康查体儿童为对照组(n=32),首次治疗后有缓解的HLH患儿为缓解组(n=11),检测并分析各组儿童血清中HSP70的表达,同时对白细胞介素6(interleukin 6,IL-6)、白细胞介素10(interleukin 10,IL-10)、γ干扰素(interferon gamma, IFN-γ)、淋巴细胞亚群等指标进行检测并分析。结果 HLH组患儿HSP70水平高于脓毒血症组和对照组,差异具有统计学意义(P<0.001)。HLH组患儿IL-10和IFN-γ水平高于脓毒血症组和对照组,差异具有统计学意义(P<0.001)。HLH组患儿IL-6水平高于对照组(P<0.001),虽低于脓毒血症组,但差异无统计学意义(P>0.05)。HLH组患儿HSP70水平高于缓解组,差异具有统计学意义(P<0.001)。结论 儿童HLH急性期血清中HSP70浓度高于脓毒血症患儿和健康患儿,对早期识别并鉴别诊断儿童HLH和脓毒血症具有潜在临床价值。联合分析HSP70和IL-10、IFN-γ结果有助于早期辅助判断HLH患儿的病情发展趋势和严重程度。Objective To explore the expression and clinical significance of heat shock protein 70(HSP70)in ser-um of hemophagocytic lymphohistiocytosis(HLH)in children.Methods Children who diagnosed with HLH at author'shospital from September 2019 to August 2021 were selected as the HLH group(n=12),Children with sepsis were se-lected as the sepsis group(n=45),while healthy children underwent routine physical examinations were selected as thecontrol group(n=32).Additionally,HL.H child patients who achieved remission following initial treatment were classi-fied as the remission group(n=11).The expression of HSP70 in serum of children in each group was detected,the levelsof interleukin 6(Il-6),interleukin 10(IL-10),interferon gamma(IFN-y)and lymphocyte subpopulation were assessed.Results The level of HSP70 in the HLH group was higher than that in sepsis group and control group(P<0.001).Thelevels of Il-10 and IFN-y in HL.H group were higher than those in sepsis group and control group(P<0.001).The ll-6 level was higher in the HlLH group compared with control group(P<0.001),but lower than that in the sepsis groupwhile there was no statistical significance between the two groups(P>0.05).The serum concentration of HSP70 in theHLH group was higher than that in the remission group(P<O.001).Conclusion The serum concentration of HSP70 ishigher in children with HLH compared with children with sepsis and health children,it suggests that HSP70 can serve asa potential novel biomarker for the early identification and differential diagnosis of HLH and sepsis in child patients.The combination analysis ofHSP70,IL-10,and IFN-youtcomes may facilitate the early evaluation of diseaseprogression and severity in child patients with infectioussymptoms.

关 键 词：噬血细胞性淋巴组织细胞增生症 脓毒血症 热休克蛋白70 白细胞介素10 Γ干扰素 

分 类 号：R725[医药卫生—儿科]