血清蛋白指纹技术在冠心病不稳定型心绞痛诊断中的应用  

Use of protein fingerprint patterns in serum to identify patients with unstable angina

作　　者：冯凯[1] 赵文度[2] 郑燕华[1] 卿恩明[2] 张建中[1] 张铭[1] 景青萍[1] 邹德威[1] 

机构地区：[1]解放军第306医院中心实验室,北京100101 [2]首都医科大学附属北京安贞医院麻醉科

出　　处：《中华急诊医学杂志》2007年第5期496-499,共4页Chinese Journal of Emergency Medicine

基　　金：国家重点基础研究发展规划资助项目(G1999054200)

摘　　要：目的采用蛋白质组学新技术筛选冠心病不稳定型心绞痛(unstable angina,UA)患者血清蛋白标志分子,建立诊断不稳定心绞痛的蛋白分类模型。方法冠心病不稳定型心绞痛患者48例,男28例,女20例;正常健康人60例,患者出现症状24h内采血,分离血清。样本分为两组:第一组为训练组,包括UA患者和正常健康人各30例,性别年龄相当;第二组为盲法分析组,包括剩余18例UA患者和26例正常健康人。利用(surface enhanced laser desorption/ionization time of flight mass spectrometry,SELDI-TOF-MS)技术对血清样本进行蛋白质谱分析。采用蛋白飞行质谱仪(PBSⅡ-C型)对结合在WCX2芯片上的血清蛋白进行读取分析。采用Ciphergen Proteinchip 3.1软件分析分组数据及相关性,Biomarker Wizard软件对不同组相同质荷比的蛋白含量进行t检验,P<0.01时具有统计学意义,用Biomarker Patterns System建立分类树模型。结果UA患者与正常人血清蛋白组比较后发现了25个表达差异蛋白,其中13个蛋白在UA患者血清中高表达,12个低表达。软件分析系统利用上述蛋白建立了一个分类模式,在训练组中敏感性和特异性均为96.6%。盲法分析显示其对UA患者的诊断敏感性为94.4%,特异性为100%,阳性预测值为100%,阴性预测值96.3%。结论SELDI技术能够有效快速地从血清中筛选出UA患者相关的标志蛋白分子,利用蛋白模式分类方法对冠心病患者进行风险评估和冠心病的筛查是一个比较好的方法。Objective To screen serum biomarkers for early diagnosis of patients with unstable angina. Method A total of 48 patients with unstable angina （UA） and 60 healthy controls were included in this study. Samples were drawn from patient within 24 hours after angina occurred. The samples were divided into two groups： （1） training group including 30 UA patients and 30 healthy controls respectively; （2） blinding group, including the remained. Serum proteomic spectra were analyzed by surface enhanced laser desorption/ionization time of flight mass spectrometry （SELDI-TOF-MS） technology. WCX2 chip was used for protein binding. Ciphergen Proteinchip 3.1 was used to analyse data and correlation. Biomarker Wizard software was used to condact t test for relative content of protein in samples of the same m/e ratio （ P value 〈 0.01 was considered statistically significant）. Biomarker Patterns System was used to construct cluster tree model. Results Twenty five kinds of protein with differential expression were found between UA patients and healthy controls, and compared with healthy controls, 13 kinds protein were highly expressed in UA patients and 12 were lowly expressed. The 25 kinds protein was analyzed by SELDI - TOF - MS and showed： the sensitivity and specificity of was 96.6%, respectively. In blind group, the sensitivity was 100%, specificity 94.4%, positive predictive value of 100%, and negative predictive value of 96.3 %. Conclusions SELDI couldbe used to screen typical protein in UA patients. Proteomic pattern technology could be a good method for evaluating risk and screening coronary disease.

关 键 词：表面增强离子解析电离飞行时间质谱 不稳定性心绞痛 生物标志分子 

分 类 号：R541.4[医药卫生—心血管疾病]