应用蛋白质指纹图谱建立炎性和非炎性早产诊断模型  

Application of proteomic models for the diagnosis of inflammatory and non-inflammatory pretermdelivery

作　　者：张文颖 党艳丽 周玲 于力 刘艮兰 张妍 陈秀芳 王敏 张军 

机构地区：[1]解放军三○六医院妇产科,北京100101 [2]解放军三○六医院病理实验科,北京100101

出　　处：《中华医学杂志》2011年第47期3329-3332,共4页National Medical Journal of China

基　　金：首都医学发展科研基金（2007-3039）

摘　　要：目的建立炎症早产和非炎症早产血清蛋白质组诊断模型。探讨应用蛋白质指纹技术进行早产的早期预警并区分炎症早产。方法从2008至2010年在解放军第三。六医院住院分娩的产妇中挑选250例作为研究对象，根据人选条件和分娩后胎盘胎膜的病理结果，分5组每组50例：炎症早产组，非炎症早产组，盲法验证组和炎症足月产组；用正常足月产组做对照。各组标本50例，共250例。应用SELDI-TOF-MS蛋白质指纹技术和生物信息学方法，建立炎症和非炎症早产诊断模型并经过盲法验证和统计学分析；同时将炎症早产组和炎症足月产组建模所用差异蛋白进行比较分析。结果炎症早产组与对照组质谱比较，得出36个差异蛋白，使用相对分子质量为1089、6635、2875、10068、4405、4971、36665、9713的标志蛋白建立模型。其特异度80．85％，敏感度84．44％，阳性预测值93．33％，阴性预测值46．67％；非炎症早产组共有15个差异蛋白，使用相对分子质量为3941、5808、6858、4289的标志蛋白建模，其特异性75．68％，敏感性64．44％，阳性预测值80．00％，阴性预测值66．67％。诊断炎症早产和诊断炎症足月产所用的模型比较得知，两者所用的差异蛋白完全不同。结论应用血清蛋白质组诊断模型预测早产，能够将炎症早产和非炎症早产加以区分，具有指导个性化治疗的临床应用前景。炎症早产和炎症足月产的诊断模型完全不同，推测在妊娠的不同时期，绒毛膜羊膜炎所导致的相关蛋白质的表达不同。Objective To establish the serum proteomic models for the identification of premature delivery with inflammation or non-inflammation. Methods The laboring patients from 2008 to 2010 at our hospital were divided into 5 groups according to placental pathology, including inflammatory preterm group, non-inflammatory preterm group and blind test group （ n = 50 each）. The control group was normal full- term. The preterm models with or without inflammation were established by the methods of SELDI-TOF-MS （matrix-assisted laser desorption/ionization-time of flight-mass spectrometry ） and bioinformatics. And statistical analysis was performed after a blind test. Then differential protein fingerprints were compared and analyzed. Results A total of 36 different proteins were harvested after a comparison of inflammatory preterm and control groups. The model was established by eight markers. The rates of specificity, sensitivity, positive predictive value and negative predictive value were 80. 85%, 84.44%, 93.33% and 46.67% respectively. Fifteen different proteins existed between non-inflammatory preterm and control groups. There were 4 marker proteins. The rates of specificity, sensitivity, positive predictive value and negative predictive value were 75.68% , 64. 44%, 80. 00% and 66. 67% respectively. Different marker proteins existed between the identification models of inflammatory preterm labor and inflammatory full-term. Conclusion Different serum proteomic models may be used for the diagnosis of preterm labor and the differentiation ofpreterm labor with or without inflammation. And different proteins are expressed during different stages of pregnancy with chorioamnionitis.

关 键 词：早产 炎症 诊断 蛋白质组学 

分 类 号：R714.21[医药卫生—妇产科学]