IgA肾病血瘀证血清蛋白组学的初步研究

Serum Proteomic Study on IgA Nephropathy with Blood Stasis Syndrome

目的：应用表面增强激光解吸/电离飞行时间质谱技术（SELDI-TOF-MS技术）检测IgA肾病患者的血清蛋白质指纹图谱,试图寻找IgA肾病血瘀证相关的差异蛋白质,从蛋白质水平探索IgA肾病血瘀证血清的标志物.方法：采集于2011年10月～2013年2月肾内科住院的IgA肾病患者的血液样本共30例（血瘀证14例,非血瘀证16例）,同时采集健康人血液样本15例.研究各组病例血清蛋白质指纹图谱,所有蛋白质质谱采用Biomarker Wizard分析之后用Biomarker Patterns Software软件识别IgA肾病血瘀证特异表达的蛋白质,并建立证候决策模型.结果：（1）IgA肾病血瘀证患者与正常人血清蛋白质指纹图谱数据比较,经分析检测到30个蛋白质峰差异具有统计学意义（P＆lt;0.05）.（2）IgA肾病血瘀证患者与非血瘀证患者血清蛋白质指纹图谱数据比较,经分析检测到42个蛋白质峰差异具有统计学意义（P＆lt;0.05）.（3）IgA肾病血瘀证差异表达蛋白峰的筛选及证候决策模型的建立.经筛选质荷比为1 092.71（低表达）、1 972.32（低表达）、2 687.74（低表达）、3 196.19（高表达）、3 249.02（高表达）、8 567.20（高表达）、8 713.48（高表达）的7个蛋白峰组成的证候决策模型能很好区分IgA肾病血瘀证,该模型的敏感性为92.85%,特异性为93.75%,进一步对决策模型进行盲法验证,此模型对血瘀证的诊断敏感性为85.71%,特异性为81.25%.结论：M/Z为1 092.71、1 972.32、2 687.74、3 196.19、3 249.02、8 567.20、8 713.48的7个蛋白峰可能是区分IgA肾病血瘀证与非血瘀证的血清蛋白标志物.

Objective： Using the SELDI - TOF - MS technology to detect the serum protein fingerprints of IgA nephropathy and find out the serum differentially expressed proteins of the blood stasis syndrome of IgA nephropathy; in order to explore the serum protein markers of the blood stasis syndrome of IgA nephropathy. Methods： Collected 30 blood samples of IgA nephropathy from renal medical wards of Nanjing General Hospital of Fuzhou Military Command between October 2011 and February 2013, including 14 cases of blood stasis syndrome and 16 cases of non -blood stasis syndrome; collected 15 blood samples of normal persons. Proteomics meth- ods （SELDI- TOF- MS technology and metal ion chelating protein chip） were applied to explored the serum protein fingerprints of each group. After all the proteomic fingerprints being analyzed by Biomarker Wizard, the special expressed proteins for blood stasis syndrome were identified byBiomarker Patterns Software to create the syndrome decision model. Results：According to the comparison of the serum protein fingerprint datas, 30 difference protein peaks between patients of IgA nephropathy with blood stasis syndrome and healthy persons （P 〈 0.05 ）, and 42 difference protein peaks between patients of blood stasis syndrome and non - blood stasis syn- drome were detected （ P 〈 0.05 ）. A decision model consisted 7 screened out protein peaks with mass - to - charge ratio of 1 092.71, 1 972.32,2 687.74,3 196.19,3 249.02,8 567.20 and 8 713.48 was created, which could well differentiate the blood stasis syndrome,with the sensitivity of 92.85%, specificity of 93.75%. Further blind test for prospective check showed its sensitivity being 85.71%, specificity 81.25 %. Conclusion： The protein peaks with mass - to - charge ratio of 1 092.71,1 972.32,2 687.74, 3 196.19,3 249.02,8 567.20and 8 713.48 could be used for distinguishing IgA nephropathy with blood stasis syndrome and non - blood stasis syndrome.