Study On The Correlation Of Expression Of Stressing Proteins In Peripheral Blood With Traumatic Stress

Objective:To Study the expression of stress protein HSP70 and PCT and the changes of the concentration of plasma cell-free DNA and concentration of serum of CHOL and whole blood WBC of patients with acute trauma in different stages to provide research datas for the farther study of pathological mechanism and to provide experimental evidence for inspection and treatment of the acute trauma.Methods:57 cases of acute trauma patients, met the research standards, were divided into three groups, mild group (ISS≤8), moderate group (ISS 9-15) and severe group (ISS≥16) by ISS.33 patients of 57 cases were divided into inflection and non-inflection groups based on clinical outcome.30 healthy people were treated as control group. Blood specimens of injured patients were collected at different stage after injury 1-6h,24-36h and 60-90h. Serum HSP70 tested by enzyme-linked immunorbent assay (ELISA), serum PCT and CHOL tested by immunoturbidimetry and enzymatic-measure respectively. Whole blood WBC counted by automatic blood analysis, and plasma cell-free DNA by RT-PCR.Results:1,The level of serum HSP70 of the patients of all groups increased after injured 1-6h and three patient groups were significantly higher than control group and the level of serum HSP70 of severe group were significantly higher than other two injury groups; the level of serum HSP70 of TBI patients were significantly higher than non-TBI injured group at the first and second stages; the level of serum HSP70 of inflection group was significantly higher than non-inflection group from second stage, and keep increasing.2,There was no significant increase can be seen at first stage of level of serum PCT of all patient groups and three stages of mild injury group; The level of serum PCT of moderate and severe groups were significant higher than control group from second stage; the level of serum PCT of both infection and non-infection groups was increase after injured 24-36 h, then decrease of non-infection group, continue increase of infection group.3,WBC of all patients increased after injured 1-6 h, and the extent of increase of WBC was related to trauma degree, but all groups put up the trend of decrease subsequently; The WBC of infection groups was significant higher than control group at all stages and significant higher than non-infection group from second stage; the WBC of non-infection group back normality after injured 60-90h.4,The concentration of serum CHOL of severe trauma group was significant lower than that of control group and the other trauma groups and showed a decreaseing trend. The concentration of serum CHOL after injured 60-90h was significant lower than that of after injured 1-6h. There was significant different can be seen between infection group and control group from second stage.5,The positive rate of plasma cell-free DNA was 100% in death group, and total patients was 29.8%, and patients with surgical treatment was 37%,0.3% in healthy control group. No significant difference can be seen between mild group and severe group.Conclusions:1,The persistent expression of stress protein Hsp70 and PCT and persistent decrease of the concentration of CHOL of serum were the symbol of infection in trauma patient.2,WBC was a good parameter to estimate the degree of injury, but WBC call-back cauld not be used as an evidence of disease recover.3,The levels of HSP70,PCT,WBC,CHOL can help to evaluate the degree of stress and to forecast the trend of disease by associated testing and dynamic observing.4,There were no evident correlation between cell-free DNA and injury degree, but persistently increase meant bad outcome.