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目的用表面增强激光解吸离子化飞行时间质谱仪(SELDI-TOF-MS)检测慢性移植物肾病(CAN)患者血清蛋白质图谱,构建CAN血清蛋白质指纹图谱及其对该病的早期诊断作用。方法用SELDI-TOF-MS及弱阳离子交换芯片(CM10)检测24例移植肾功能完全正常的长期存活者(LS)和15例CAN患者的血清蛋白质图谱,并运用软件判别和分析处理数据,筛查特异的蛋白质分子标志物。结果对每份血清样本,质谱系统产生78个有意义的蛋白质峰,18个蛋白质的差异在两者间具有统计学意义(P<0．05),6个蛋白质(质荷比2476．0,3078．7,3190．5,4076．5,4506．0,6178．4)有极其显著差别(P<0．01),以质荷比3078．7为单一分子标志物可区别LS和CAN患者(P=0．0001),它在前者高表达,在后者低表达,其诊断CAN时的敏感性为87．5％,特异性为81．8％,其诊断作用绩效比为0．307。结论SELDI-TOF-MS构建的血清蛋白质指纹图谱在诊断CAN时具有较高的价值。
Objective To detect serum protein profiles of patients with chronic allograft nephropathy (CAN) by surface enhanced laser desorption / ionization time-of-flight mass spectrometry (SELDI-TOF-MS) and construct the serum protein fingerprinting of CAN and its early diagnostic effect on the disease. Methods SELDI-TOF-MS and weak cation exchange chip (CM10) were used to detect serum protein profiles of 24 long-term survivors (LS) and 15 CAN patients with completely normal renal allograft function. The software was used to discriminate and analyze the data. Find specific protein molecular markers. Results For each serum sample, 78 significant protein peaks were generated in the mass spectrometry system. The differences of 18 proteins were statistically significant (P <0.05) and 6 proteins (mass-to-charge ratio, 2476.0, 3078.7, 3190.5, 4076.5, 4506.0 and 6178.4) (P <0.01). The mass-to-charge ratio of 3078.7 could be used as a single molecular marker to distinguish patients with LS and CAN (P = 0.0001), which was highly expressed in the former and low in the latter. The sensitivity and specificity of diagnosing CAN were 87.5% and 81.8% respectively, and the diagnostic performance was 0.307 . Conclusion Serum protein fingerprinting constructed by SELDI-TOF-MS is of high value in the diagnosis of CAN.