急性缺血性脑卒中患者妊娠相关血浆蛋白A超敏检测方法的建立及评价  

Establishement of ultrasensitive detection of pregnancy associated plasma protein A in ischemic stroke and the evaluation

作　　者：曾昭伟[1] 陈淑莲 常艳敏[1] 王学谦[1] ZENG Zhao-wei;CHEN Shu-lian;CHANG Yan-min(Department of Clinical Laboratory,Tianjin Nankai Hospital,Tianjin300100,China)

机构地区：[1]天津市南开医院检验科,天津300100

出　　处：《中国实验诊断学》2020年第4期549-552,共4页Chinese Journal of Laboratory Diagnosis

基　　金：天津市卫生健康委科技基金(2013KY24);天津市卫生健康委、天津市中医药管理局中医、中西医结合科研项目(2019043)。

摘　　要：目的探讨超敏妊娠相关血浆蛋白A(PAPP-A)检测方法及对急性缺血性脑卒中(IS)的诊断评价。方法筛选PAPP-A抗原表位富集区,制备重组PAPP-A抗原及相应抗体。利用化学发光法与磁性微球标记相结合建立均相发光检测方法,评价方法学指标,并与时间分辨免疫荧光法比对。分别对IS患者,包括39例轻度患者,43例中度患者以及36例重度患者和40例正常对照组的血浆PAPP-A水平初步检测评价。结果本研究建立基于磁性微球标记和抗原表位分析的化学发光检测方法,对血清中的PAPP-A检测能达到高灵敏度和高特异度,且本方法稳定性良好。PAPP-A浓度在IS患者较对照组升高,且在轻中重度各组差异有统计学意义(P<0.05)。结论PAPP-A是IS可靠生物标志物之一。微球标记增大反应面积,有效提高反应灵敏度,筛选抗原表位增强了特异度,利用本方法可有效检测出IS血清中微量PAPP-A,并对不同病程有良好区分,对IS的早期诊断有重要意义。Objective To determine the clinical significance of the novel ultrasensitive detection of pregnancy associated plasma protein A in ischemic stroke.Methods The recombined antigen of PAPP-A was prepared through screening epitope enriched region,the associated antibody was established.The combination of high sensitive chemiluminescence and tagged microspheres contributes to establish the method,which was validated and used clinically to compare with time-resolved fluoroimmunoassay(TRFIA).IS patients including 39 mild,43 moderate and 36 severe patients were enrolled to test serum PAPP-A,so were 30 normal controls.Results The chemiluminescence based on microspheres labeling and epitope analysis was created,which could enhance the sensitivity and specificity of detecting PAPP-A in IS,the stability was acceptable.PAPP-A concentration in IS was higher than in normal controls,so was it in different degrees,the differences were significant(P<0.05).Conclusion Being apotential biomarker,PAPP-A is associated with IS closely.Sensitivity was improved through expanded response surface of tagged microspheres,specificity was augmented by specific epitope picked.So we can detect traces of PAPP-A in IS using the method,which is favorable to strengthen the clinical significance in early diagnosis of IS.

关 键 词：妊娠相关血浆蛋白A 急性缺血性脑卒中 化学发光 表位分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]