感染性疾病个性化实验室诊断时代的到来：质谱技术的深入开发与临床应用  

New era of individual laboratory diagnosis in infectious diseases is coming： the further exploration and clinical application of mass spectrometry

作　　者：李修远[1] 李雪[1] 鲁辛辛[1] 

机构地区：[1]首都医科大学附属北京同仁医院检验科,100730

出　　处：《中华检验医学杂志》2017年第10期756-760,共5页Chinese Journal of Laboratory Medicine

摘　　要：感染性疾病的精准诊疗关乎患者生命，其中快速、高效、准确且全面的实验室检测扮演了重要角色。质谱技术的出现，在临床实验室生物大分子检测中掀起了一场革命。而对于感染性疾病实验室诊断的贡献，则以基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）最为突出。若对MALDI-TOF MS的原理及微生物专业知识了解足够全面，不但能够发现一些容易忽视的细节，更能对其进行深入开发、拓展应用，使之锦上添花。另一方面囊括MALDI-TOF MS、液相色谱-质谱（LC-MS）及气相色谱-质谱（GC-MS）的全息质谱也就成为了临床实验室的终极理想。多种质谱技术的整合形成优势互补，应用范围更广泛，不仅可以精确诊断病原微生物，还可实现感染相关致病标志物、代谢产物的检测，以获得病原体及宿主双向的信息，使得感染性疾病的实验室诊断更为全面、精准、个性化。全息质谱的应用使感染性疾病的诊断突破传统方法，在体现快速准确的同时，反映了科学技术水平与研究能力的提升。Accurate diagnosis and treatment of infectious diseases are vital, in which rapid, efficient, precise and comprehensive laboratorial detection plays a crucial role. The emergence of mass spectrometry technique revolutionized the test for biomacromolecule in clinical laboratory. The contribution of matrix-assisted laser desorption/ ionization time of flight mass spectrometry （MALDI-TOF MS） for laboratory diagnosis of infectious diseases was particularly significant. With the knowledge about the principles of MALDI-TOF MS and microbiology, it is not only able to allow you to have an insight into the details, but also help you to further develop and expand the application. Holographic mass spectrometry consists of, liquid chromatography-mass spectrometry （LC-MS） and gas chromatography-mass spectrometer （GC-MS） becomes a pipe dream. The combination of the three mass spectrometer technologies complement each others advantages, so that the application can be extended. They can not only accurately confirm the pathogens, but also detect the immune response products, metabolite and molecular markers of infectious diseases in order to obtain more comprehensive information of both pathogens and hosts, so that the laboratorial diagnosis can be more comprehensive, precise and individual. The application of holographic mass spectrometry breaks through the classic method and nucleic acid detection technology. It can not only embody speediness and accuracy, but also reflect the promotion of science level and research capability.

关 键 词：传染病 质谱分析法 临床实验室技术 个体化医学 

分 类 号：O657.63[理学—分析化学] R51[理学—化学]