应用蛋白质指纹图谱技术快速鉴别诊断菌阴肺结核

Rapid identification of bacteriological negative pulmonary TB and lung disease by proteomic fingerprinting technology

目的探索应用蛋白质指纹图谱技术于菌阴肺结核与肺炎的鉴别诊断。方法从本院临床病例中,选择菌阴肺结核和肺炎患者及健康者各60例,应用表面加强激光解吸电离飞行时间质谱技术(SELDI/ToF-Ms)和蛋白芯片技术检测血清蛋白,并应用Ciphergen蛋白芯片3.1.1软件进行比较,分析其相关蛋白峰值并进行统计学处理。结果对180例菌阴肺结核、肺炎患者、健康者的血清蛋白指纹图谱数据进行比较,发现有5个蛋白峰(1 028.49、4 796.56、7 564.77、8 048.02、11 526.75m/z)存在显著的差异,有统计学意义(P<0.01)。由这5个蛋白峰组成的诊断模型鉴别诊断菌阴肺结核与肺炎的总有效率84.2%(101/120),敏感性与特异性分别为82.5%(52/63),85.9%(49/57);阳性预测值86.7%(52/60),阴性预测值为81.7%(49/60)。诊断模型在判别肺炎、菌阴肺结核患者与健康者之间,总有效率达89.4%(161/180),特异性为100%(60/60),灵敏度为84.2%(101/120),阳性预测值100%(101/101),阴性预测值75.9%(60/79)。结论蛋白质指纹图谱技术具有方法简便、检测快速,标本用量少的优点,是筛选结核病特异性标志物的有效手段,通过蛋白质指纹图谱技术检测,发现了具有良好鉴别诊断的"诊断模型"。

To explore the application of protein fingerprint technique and differential diagnosis in bacteriological negative pulmonary tuberculosis and pneumonia ,60 patients with bacteriological negative pulmonary tuberculosis ,60 patients with pneumonia ,and 60 healthy volunteers were selected from known clinical cases .Surface strengthening laser desorption ioniza-tion time of flight mass spectrometry （SELDI ToF Ms） and protein chip technology were applied to detect serum proteins ,and analyze their protein peaks by Ciphergen protein chip 3 .1 .1 software .Comparison of the serum protein fingerprinting data from the pool of 180 patients and healthy volunteers showed significant difference in 5 protein peaks （1 028 .49 ,4 796 .56 ,7 564 .77 , 8 048 .02 ,and 11 526 .75 m/z） identified between pulmonary tuberculosis and pneumonia （P〈0 .01） .The total effective rate of the 5 protein peaks as a diagnosis model for differential diagnosis of bacteriological negative pulmonary tuberculosis and pneumonia was 84 .2% （101/120） ,the specificity was 82 .5% （52/63） ,the sensitivity was 85 .9% （49/57） ,the positive pre-dictive value was 86 .7% （52/60） ,and the negative predictive value was 81 .7% （49/60） .The total effective rate of the diagno-sis model for differential diagnosis of bacteriological negative pulmonary tuberculosis ,pneumonia and healthy volunteers was 89 .4% （161/180） .The specificity was 100% （60/60） ,the sensitivity was 84 .2% （101/120） ,the positive predictive value was 100% （101/101） ,and the negative predictive value was 75 .9% （60/79） .Protein fingerprinting technology is advanta-geous of being a simple method ,quick detection ,and requires less amount of sample .It is an effective means to screening the tuberculosis specific markers .We found the good diagnosis model through the detection of serum protein by protein fingerprint-ing technology .