外周血热休克蛋白60、热休克蛋白70与AECOPD患者NLRP3炎性小体和疾病转归的关系  

A study on the relationship between peripheral blood heat shock protein 60,heat shock protein 70 and NLRP3 inflammasome and disease regression in patients with AECOPD

作　　者：豆哲敏 叶丹[1] 韩磊[1] 臧桂琴 DOU Zhemin;YE Dan;HAN Lei;ZANG Guiqin(Department of Emergency,Beijing Aerospace General Hospital,Beijing,100076,China)

机构地区：[1]北京航天总医院急诊科,北京100076

出　　处：《临床急诊杂志》2025年第2期121-126,共6页Journal of Clinical Emergency

基　　金：北京市科技发展指导性计划项目(No:BJSW2020012)。

摘　　要：目的:探究外周血热休克蛋白60(heat shock protein 60,HSP60)、HSP70与慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性小体和疾病转归的关系。方法:选取2020年1月—2023年3月北京航天总医院收治的275例AECOPD患者,同期选取性别、年龄与之匹配的COPD稳定期患者200例、体检健康者200例作为对照,并依次设为AECOPD组、COPD稳定期组、健康组。比较3组外周血HSP60、HSP70水平以及外周血单个核细胞中NLRP3 mRNA相对表达量及其相关炎性因子[白介素-1β(interleukin-1β,IL-1β)、IL-18]水平,采用Pearson检验分析AECOPD患者外周血HSP60、HSP70水平与NLRP3 mRNA、IL-1β、IL-18的相关性。AECOPD患者出院后随访观察1年,评估疾病转归情况,根据疾病转归情况分为好转组和恶化组,单因素和多因素logistic回归分析AECOPD患者出院后1年内病情恶化的危险因素。结果:与健康组、COPD稳定期组比较,AECOPD组外周血HSP60、HSP70、IL-1β、IL-18水平及外周血单个核细胞NLRP3 mRNA相对表达量显著升高,差异有统计学意义(P<0.05);且AECOPD组上述指标显著高于COPD稳定期组,差异有统计学意义(P<0.05)。Pearson检验显示,AECOPD患者HSP60、HSP70与NLRP3 mRNA、IL-1β、IL-18均呈正相关(P<0.05)。与好转组比较,恶化组改良版英国医学研究委员会呼吸困难量表(modified british medical research council dyspnea scale,mMRC)分级>2级占比、外周血HSP60、HSP70、NLRP3 mRNA、IL-1β、IL-18显著升高(P<0.05)。mMRC分级>2级、外周血HSP60升高、HSP70升高、NLRP3 mRNA升高是AECOPD患者出院后1年内病情恶化的危险因素(P<0.05)。结论:AECOPD患者外周血HSP60、HSP70高表达与NLRP3炎性小体活化及病情恶化相关,有望成为AECOPD诊疗和疾病转归的潜力指标。Objective To explore the relationship between peripheral blood heat shock protein 60(HSP60),heat shock protein 70(HSP70)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome and disease outcome in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 275 AECOPD patients admitted to our hospital from January 2020 to March 2023 were selected,200 patients with stable COPD and 200 healthy subjects matched by gender and age were selected as controls at the same time,and they were set as AECOPD group,COPD stable group and healthy group in turn.The peripheral blood HSP60 and HSP70 levels were compared among the three groups,and the relative expression of NLRP3 mRNA and the levels of its related inflammatory factors(IL-1β,IL-18)were compared among the three groups of peripheral blood mononuclear cells,and the Pearson test was used to analyze the correlation between the peripheral blood HSP60 and HSP70 levels of the AECOPD patients and the correlation of NLRP3 mRNA,IL-1β,IL-18.AECOPD patients were followed up for 1 year after discharge to evaluate the regression of the disease,and they were divided into improvement group and deterioration group according to disease regression,and risk factors for deterioration of AECOPD patients within 1 year after discharge were analyzed by univariate and multivariate logistic regression analysis.Results Compared with healthy group and stable COPD group,the levels of HSP60,HSP70,IL-1β,IL-18 and the relative expression of NLRP3 mRNA in peripheral blood mononuclear cells in AECOPD group were significantly increased(P<0.05),compared to the stable COPD group,the aforementioned indicators in AECOPD group were considerably higher(P<0.05).Pearson test showed that,HSP60 and HSP70 were positively correlated with NLRP3 mRNA,IL-1β and IL-18 in AECOPD patients(P<0.05).Compared with improvement group,the proportion of modified british medical research council dyspnea scale(mMRC)grade>2,peripheral blood HSP60,HSP70,N

关 键 词：热休克蛋白60 热休克蛋白70 慢性阻塞性肺疾病急性加重期 核苷酸结合寡聚化结构域样受体蛋白3 疾病转归 

分 类 号：R473.5[医药卫生—护理学]