【摘要】：目的探討熱休克蛋白70在膽道閉鎖(BA)肝組織纖維化中的作用及對預(yù)后的影響。方法選取擇期行Kasai術(shù)治療的BA患兒46例、膽總管囊腫患兒30例和門靜脈海綿樣變患兒17例;免疫組化染色檢測肝組織中HSP 70蛋白表達(dá),利用天狼星紅-飽和苦味酸染色液檢測BA患兒肝組織纖維化,雙重染色法檢測BA患兒不同纖維化肝組織中HSP 70蛋白表達(dá),所有BA患兒術(shù)后均獲得隨訪。結(jié)果 BA、膽總管囊腫以及靜脈海綿樣變患兒三組,HSP 70蛋白高表達(dá)比例的差異有統(tǒng)計(jì)學(xué)意義(χ~2=7.99,P=0.018),以BA組的HSP 70蛋白高表達(dá)比例為最高。等級相關(guān)分析顯示,肝組織中HSP70蛋白表達(dá)強(qiáng)度與肝纖維化程度呈正相關(guān)(r=0.861,P0.001);46例BA患兒中,死亡15例,生存分析顯示,輕度BA患兒術(shù)后生存率82.4%,中位生存時(shí)間(34.6±2.3)月;中重度患兒術(shù)后生存率58.6%,中位生存時(shí)間(25.5±2.8)月;Log-Rank檢驗(yàn)顯示,兩組生存函數(shù)的差異有統(tǒng)計(jì)學(xué)意義(χ~2=5.27,P=0.012)。BA患兒中,HSP 70蛋白低表達(dá)者的生存率85.0%,術(shù)后中位生存時(shí)間(34.0±2.6)月,HSP70蛋白高表達(dá)者生存率53.8%,術(shù)后中位生存時(shí)間(18.3±2.2)月;Log-Rank檢驗(yàn)顯示,兩組生存函數(shù)差異有統(tǒng)計(jì)學(xué)意義(χ~2=4.77,P=0.029)。結(jié)論 BA患兒肝組織中HSP70蛋白呈高表達(dá),且與肝組織纖維化程度呈正相關(guān),推測其可能參與了肝纖維化進(jìn)程,HSP70表達(dá)上調(diào)往往預(yù)示患兒預(yù)后不良。
[Abstract]:Objective to investigate the role of heat shock protein 70 (HSP70) in hepatic fibrosis of biliary atresia (BA) and its influence on prognosis. Methods 46 cases of BA, 30 cases of choledochal cyst and 17 cases of portal cavernous degeneration were selected. Immunohistochemical staining was used to detect the expression of HSP 70 protein in liver tissue, Sirius red saturated picric acid staining solution was used to detect liver fibrosis in children with BA, and double staining method was used to detect the expression of HSP 70 protein in different fibrosis liver tissues of BA children. All children with BA were followed up after operation. Results the high expression ratio of HSP 70 protein in BA, choledochal cyst and cavernous venous degeneration group was significantly higher than that in BA group (蠂 ~ 2 = 7.99). The highest expression rate of HSP 70 protein was found in BA group. Grade correlation analysis showed that there was a positive correlation between the expression of HSP70 protein and the degree of hepatic fibrosis. Survival analysis showed that the survival rate of mild BA patients was 82.4 months and the median survival time was (34.6 鹵2.3) months. The survival rate was 58.6 months and the median survival time was (25.5 鹵2.8) months. Log-Rank test showed that there was a significant difference in survival function between the two groups (蠂 ~ 25.27 / 0. 012). BA). The survival rate of patients with low expression of HSP 70 protein was 85.0 and the median survival time was (34. 0 鹵2. 6) months. The survival rate of the patients with high expression of HSP70 protein was 53.8% and the median survival time was (18.3 鹵2.2) months. Log-Rank test showed that the difference of survival function between the two groups was statistically significant (蠂 ~ 2 ~ (4.77) P ~ (0.029). Conclusion there is a high expression of HSP70 protein in liver tissue of children with BA, and it is positively correlated with the degree of hepatic fibrosis. It is speculated that it may participate in the process of hepatic fibrosis, and the up-regulation of HSP70 expression may predict the poor prognosis of the children.
【作者單位】： 鄭州市兒童醫(yī)院小兒外科;
【分類號】：R725.7

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