耐多药肺结核患者血清蛋白指纹图谱测定初步研究

Preliminary study on the application of protein fingerprinting technology for multidrug-resistant tuberculosis patients

目的评价血清蛋白指纹图谱技术在诊断耐多药肺结核患者中的应用价值。方法选择痰Mtb培养阳性的肺结核患者70例,其中耐多药肺结核患者35例为A组,非耐药肺结核患者35例为B组;健康者35例为C组。以B、C组为对照组,应用表面增强激光解析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 protein chip 3.2.1软件进行比较,分析其相关血清蛋白峰值并进行统计学处理。结果耐多药肺结核患者组与对照组的血清蛋白质谱数据进行比较,存在4个差异有统计学意义的蛋白峰;其中质荷比(mass to charge ratio,m/z)在1369、3400m/z为低表达,而8700、22 794m/z为高表达;其灵敏度分别为77.1%(27/35)、71.4%(25/35)、80.0%(28/35)、74.3%(26/35),特异度分别为72.9%(51/70)、74.3%(52/70)、75.7%(53/70)、81.4%(57/70);χ2值分别为23.7、20.2、29.6、31.0,P值均<0.01,差异有统计学意义。结论血清蛋白质指纹图谱技术简便、快速,标本用量少,可能成为筛选耐多药肺结核一种新的检查指标。

Objective To evaluate the value of applying serum protein fingerprinting technology for multidrug-resistant tuberculosis patients.Methods Sputum cultures identified 70 cases positive for Mycobacterium tuberculosis,35 cases were multidrug-resistant and were classified as group A,35 non drug-resistant cases were classified as group B,35 healthy volunteers were classified as group C.Groups B and C were used as comparative control groups,utilizing surface-enhanced laser desorption/ionization time-of-flight mass spectrometry（SELDI-TOF-MS） and protein chips to examine serum proteins.Ciphergen protein chip 3.2.1 software is then used to analyze protein peak values and carry out statistical analysis.Results Based on the comparison of protein chip data between MDR-TB groups and controls,4 protein peak showed significant deviations（P0.01）.m/z（mass to charge ratio）for 1369 and 3400 showed low expression while those for 8700 and 22 794 showed high expression.Their sensitivities are 77.1%（27/35）,71.4%（25/35）,80.0%（28/35）,74.3%（26/35）,respectively,specificity were 72.9%（51/70）,74.3%（52/70）,75.7%（53/70）,81.4%（57/70）,respectively,all possess statistical significance（All P0.01;χ2=23.7,20.2,29.6,31.0,respectively）.Conclusion Serum protein fingerprinting technology is easy,fast,and uses small sample sizes.It has the potential to become the new diagnostic standard for MDR-TB.