关键词: 严重多发伤, 热休克蛋白70, 肠脂肪酸结合蛋白, 肠功能损伤

Abstract: Objective To investigate the changes in serum level of heat shock protein 70 (HSP70), intestinal fatty acid binding protein (IFABP) in patients with severe multiple injuries and their relationship with intestinal function damage. Methods Cases data from ninety-eight patients with multiple injuries admitted to Beijing Temple of Heaven Hospital Affiliated to Capital Medical University from December 2021 to December 2023 were collected as the diseased group. They were separated into mild group (n=52) and severe group (n=46) based on the Injury Severity Score (ISS). Additionally, 42 healthy controls that underwent physical examinations were regarded as the control group. ELISA was applied to detect serum HSP70 and IFABP level. General clinical data were collected and analyzed. Multivariate Logistic regression was applied to analyze the influencing factors of the severity of multiple injuries patients. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of serum HSP70 and IFABP for the degree of intestinal function damage in patients with severe multiple injuries. Spearman method was applied to analyze the correlation between serum HSP70, IFABP with ISS and degree of intestinal function damage. Results Compared with the control group, serum level of HSP70 and IFABP in the diseased group was significantly increased (P＜0.05). The ISS, intensive care unit(ICU) hospitalization time, serum HSP70, and IFABP levels in the severe group were higher than those in the mild group (P＜0.05). The ISS, ICU hospitalization time, and serum level of HSP70 and IFABP were all believed to be the risk factors affecting the severity of multiple injuries patients (P＜0.05). Compared with the mild group, the serum HSP70 and IFABP level in the severe group were significantly increased (P＜0.05). The AUC of HSP70, IFABP, and combined diagnosis for the degree of intestinal function damage in patients was 0.837, 0.817, and 0.950, respectively. The combined diagnosis was obviously better than individual diagnosis of HSP70 (Z=2.200, P=0.028) and IFABP(Z=2.007,P=0.045). There was a positive correlation between serum HSP70, IFABP, with ISS, the degree of intestinal function damage(P＜0.05). Conclusions The serum level of HSP70 and IFABP in patients with severe multiple injuries are significantly increased, which are closely related to the degree of intestinal function damage. So the results may facilitate diagnoses and severity evaluation of intestinal function damage of patients.

Key words: severe multiple injuries, heat shock protein 70, intestinal fatty acid binding protein, intestinal function damage