本文選題：燒傷 + 替普瑞酮��； 參考：《南昌大學(xué)》2013年碩士論文

【摘要】：目的：通過預(yù)防性應(yīng)用HSPs誘導(dǎo)劑替普瑞酮及胃鏡動(dòng)態(tài)觀察嚴(yán)重?zé)齻颊呶葛つp傷情況，同時(shí)檢測(cè)熱休克70基因及熱休克蛋白60、70的表達(dá)變化，探討HSPs誘導(dǎo)劑替普瑞酮對(duì)嚴(yán)重?zé)齻颊呶葛つさ谋Ｗo(hù)作用及HSP60、70保護(hù)胃黏膜的可能機(jī)制。 方法：將嚴(yán)重?zé)齻颊叻譃樘嫫杖鹜委熃M、常規(guī)治療組及正常對(duì)照組，其中替普瑞酮及常規(guī)治療組每組15人，正常對(duì)照組為10人。于入院第1周及第4周通過行胃鏡檢查及進(jìn)行胃黏膜標(biāo)本采集，采用免疫組化方法檢測(cè)胃黏膜HSP60、HSP70的表達(dá)；采用Realtime-PCR方法檢測(cè)胃黏膜組織內(nèi)HSP72mRNA的表達(dá)。 結(jié)果：1.胃鏡檢查及HE染色結(jié)果顯示替普瑞酮治療組胃黏膜損傷程度比常規(guī)治療組胃黏膜損傷程度明顯減輕。2.免疫組化檢測(cè)結(jié)果顯示：替普瑞酮治療組中患者傷后第1周內(nèi)的HSP60表達(dá)水平（0.1427±0.0149）明顯高于常規(guī)治療組患者傷后第1周內(nèi)的表達(dá)水平（0.1122±0.0118）及正常對(duì)照組的表達(dá)水平(0.0406±0.0037),差異有統(tǒng)計(jì)學(xué)意義（P0.05）；替普瑞酮治療組患者傷后第4周的HSP60表達(dá)水平（0.0468±0.0051）略高于常規(guī)治療組患者傷后第4周的表達(dá)水平（0.0433±0.0045）及正常對(duì)照組的表達(dá)水平(0.0406±0.0037),差異無統(tǒng)計(jì)學(xué)意義（P0.05）。替普瑞酮治療組中患者傷后第1周內(nèi)的HSP70表達(dá)水平（0.1587±0.0162）明顯高于常規(guī)治療組患者在傷后第1周內(nèi)表達(dá)水平（0.1281±0.0131）及正常對(duì)照組的表達(dá)水平(0.0402±0.0038),差異有統(tǒng)計(jì)學(xué)意義（P0.05）；替普瑞酮治療組中患者傷后第4周的HSP70表達(dá)水平（0.047±0.0048）略高于常規(guī)治療組患者傷后第4周的表達(dá)水平（0.0439±0.0044）及正常對(duì)照組的表達(dá)水平(0.0402±0.0038),差異無統(tǒng)計(jì)學(xué)意義（P0.05）。3.Real-time PCR檢測(cè)結(jié)果顯示：替普瑞酮治療組中患者在傷后第1周的HSP72mRNA表達(dá)水平（1.002±0.061）明顯高于常規(guī)治療組患者在傷后第1周的表達(dá)水平（0.797±0.049）及正常對(duì)照組的表達(dá)水平（0.312±0.033），差異有統(tǒng)計(jì)學(xué)意義（P0.05）；替普瑞酮治療組中患者在傷后第4周的HSP72mRNA表達(dá)水平（0.355±0.028）略高于常規(guī)治療組中患者在傷后第4周的表達(dá)水平（0.338±0.024）及正常對(duì)照組的表達(dá)水平（0.312±0.033），差異無統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論：替普瑞酮治療組的重度燒傷患者通過預(yù)防性的應(yīng)用HSPs誘導(dǎo)劑替普瑞酮后胃黏膜內(nèi)HSP60、HSP70的表達(dá)均比常規(guī)治療組增加，，而其胃黏膜應(yīng)激性潰瘍的嚴(yán)重程度比常規(guī)治療組要明顯減輕，這說明HSPs誘導(dǎo)劑替普瑞酮在誘導(dǎo)HSP60、70高表達(dá)后確實(shí)能對(duì)大面積燒傷后應(yīng)激性潰瘍產(chǎn)生防護(hù)作用，這為替普瑞酮在臨床上作為胃黏膜保護(hù)劑防治應(yīng)激性潰瘍提供了重要的依據(jù).
[Abstract]:Objective: to observe the gastric mucosal injury in patients with severe burn by prophylactic application of HSPs inducer tipranone and gastroscope, and to detect the expression of heat shock 70 gene and heat shock protein 6070. To investigate the protective effect of HSPs inducer tipranone on gastric mucosa in severely burned patients and the possible mechanism of HSP60P70 in protecting gastric mucosa. Methods: severe burn patients were divided into three groups: tipranone treatment group, routine treatment group and normal control group. There were 15 patients in each group in tipranone group and 10 in normal control group. The expression of HSP60 and HSP70 in gastric mucosa and HSP72mRNA in gastric mucosa were detected by immunohistochemical method and Realtime-PCR method respectively at the 1st and 4th week after admission. The result is 1: 1. The results of endoscopy and HE staining showed that the degree of gastric mucosal damage in tipranone treatment group was significantly less than that in routine treatment group. The results of immunohistochemistry showed that the expression level of HSP60 in the tipranone treatment group was 0.1427 鹵0.0149 in the first week after injury, which was significantly higher than that in the routine treatment group (0.1122 鹵0.0118) and the normal control group (0.0406 鹵0.0037). The expression level of HSP60 in the treatment group was 0.0468 鹵0.0051 at the 4th week after injury, which was slightly higher than that in the routine treatment group (0.0433 鹵0.0045) and the normal control group (0.0406 鹵0.0037). There was no significant difference between the two groups (P 0.05). The expression level of HSP70 in tipranone treatment group was 0.1587 鹵0.0162) significantly higher than that in routine treatment group (0.1281 鹵0.0131) and normal control group (0.0402 鹵0.0038), the difference was statistically significant (P 0.05). The expression level of HSP70 in ketone treatment group was 0.047 鹵0.0048 at the 4th week after injury, which was slightly higher than that in routine treatment group (0.0439 鹵0.0044) and normal control group (0.0402 鹵0.0038). The expression level of HSP72mRNA in the propranone treatment group was significantly higher than that in the routine treatment group at the 1st week after injury (1.002 鹵0.061) and in the normal control group (0.312 鹵0.033), the difference was statistically significant (P 0.05), and that of tipranone was significantly higher than that in the routine treatment group (0.797 鹵0.049) and the normal control group (0.312 鹵0.033). The expression level of HSP72mRNA in the treatment group was 0.355 鹵0.028 at the 4th week after injury, which was slightly higher than that in the routine treatment group (0.338 鹵0.024) and the normal control group (0.312 鹵0.033). There was no significant difference between the two groups (P 0.05). Conclusion: the expression of HSP60 + HSP70 in gastric mucosa of severe burn patients in tipranone group was significantly higher than that in routine treatment group. The severity of stress ulcer of gastric mucosa was significantly reduced in its gastric mucosa than that in the routine treatment group, which indicated that tipranone, the inducer of HSPs, could protect the stress ulcer after extensive burn by inducing the high expression of HSP60M70. This provides an important basis for the prevention and treatment of stress ulcer by tipranone as a gastric mucosal protector.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R644;R573

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