CAJ | 학술논문

目的应用蛋白芯片表面加强激光解析电离-飞行时间-质谱(SELDI-TOF-MS)技术检测急性重症胰腺炎不同预后相关蛋白质谱,探讨急性重症胰腺炎轻重程度及预后评估的新方法.方法用SELDI-TOF-MS方法检测浙江省人民医院2008年3月至2010年10月23例急性重症胰腺炎患者的蛋白质谱,按是否发生器官功能衰竭、胰腺脓肿、腹内压异常、死亡将全部患者分组进行蛋白指纹图谱比较.结果蛋白质峰谱特征显示,在1094 u、2751 u、5904 u处并发胰腺脓肿(13例)的重症胰腺炎患者峰值(13.21±3.73,45.62±10.31,48.37±9.24)明显高于未并发胰腺脓肿组(70例)(4.33±1.79,8.87±3.21,4.45±1.59),差异有统计学意义,均P<0.05.在635 u并发器官功能衰竭组(11例)峰值(8.56±3.21)明显低于未并发器官功能衰竭组(12例)(37.82±12.65);而在4103 u、4187 u处并发器官功能衰竭组(21.63±8.23.9.81±2.32)峰值则高于未并发器官功能衰竭组(3.32±1.29,1.14±0.49).在4173 u处并发腹内压增高组(10例)峰值(8.94±3.58)明显高于无腹内压增高组(13例)(1.97±0.73);而在5635 u处并发腹内压增高组峰值(0.62±0.23)则低于无腹内压增高组(15.78±6.34).2例死亡患者蛋白指纹表现为血清蛋白全面合成功能减退,峰值降低.结论蛋白指纹图谱技术可筛选出有意义的生物标记蛋白,为急性重症胰腺炎并发症的早期诊断与治疗提供了新的路径,对急性重症胰腺炎预后评估具有重要意义.
목적 응용단백심편표면가강격광해석전리-비행시간-질보(SELDI-TOF-MS)기술검측급성중증이선염불동예후상관단백질보,탐토급성중증이선염경중정도급예후평고적신방법.방법 용SELDI-TOF-MS방법검측절강성인민의원2008년3월지2010년10월23례급성중증이선염환자적단백질보,안시부발생기관공능쇠갈、이선농종、복내압이상、사망장전부환자분조진행단백지문도보비교.결과 단백질봉보특정현시,재1094 u、2751 u、5904 u처병발이선농종(13례)적중증이선염환자봉치(13.21±3.73,45.62±10.31,48.37±9.24)명현고우미병발이선농종조(70례)(4.33±1.79,8.87±3.21,4.45±1.59),차이유통계학의의,균P<0.05.재635 u병발기관공능쇠갈조(11례)봉치(8.56±3.21)명현저우미병발기관공능쇠갈조(12례)(37.82±12.65);이재4103 u、4187 u처병발기관공능쇠갈조(21.63±8.23.9.81±2.32)봉치칙고우미병발기관공능쇠갈조(3.32±1.29,1.14±0.49).재4173 u처병발복내압증고조(10례)봉치(8.94±3.58)명현고우무복내압증고조(13례)(1.97±0.73);이재5635 u처병발복내압증고조봉치(0.62±0.23)칙저우무복내압증고조(15.78±6.34).2례사망환자단백지문표현위혈청단백전면합성공능감퇴,봉치강저.결론 단백지문도보기술가사선출유의의적생물표기단백,위급성중증이선염병발증적조기진단여치료제공료신적로경,대급성중증이선염예후평고구유중요의의.
Objective To analyze the serum proteomic pattern in different severe acute pancreatitis complication by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) for evaluating the stage and prognosis of severe acute pancreatitis. Methods Serum samples were collected from 23 severe a-cute pancreatitis. Serum from organ nonfunction, pancreatic abscess, intra-abdominal hypertension and death were profiled using WCX Proteinchip and analyzed by mass spectrometry. Results Protein peak in the spectrum characteristics showed that at 1094u, 2751u, 5904u, the peak value of concurrent pancreas abscess pancreatitis [13.21 ± 3.73, 45.62±10.31, 48.37±9.24] were significantly higher than those in none-pancreas abscess group [4.33 ± 1.79, 8. 87 ±3.21, 4.45 ±1.59] (P<0.05). At 635u, the peak value of concurrent organ failure group(8.56 ± 3.21) was obviously lower than those in none-organ failure group(37.82 ± 12.65). At 4103u and 4187u, the peak value of in complicated organ failure group [21.63 ±8.23, 9.81±2.32] were higher than those in none-organ failure group [3.32±1.29, 1.14 ±0.49], At4173u, the peak value of concurrent increased intraabdominal pressure group(8.94 ±3.58) was significantly higher than that in none-intraabdominal pressure group(1.97 ±0. 73) , while at 5635u the peak value of concurrent increased intraabdominal pressure groups ( 0. 62 ± 0. 23 ) was lower than that without intraabdominal pressure group (15.78 ±6.34). Two cases died. Protein fingerprints showed that overall serum protein composite function dropped and the peak value reduced. Conclusion Proteomic technology can significantly identify novel significant biomarkers in the serum, which provides a new way to diagnose and treat the different complication of severe acute pancreatitis early and has clinical significance in evaluating the prognosis of severe acute pancreatitis.