CAJ | 학술논문

目的探讨危重病患者血清LGT蛋白质组的变化规律,分析其对疾病预后评估的临床意义.方法采用蛋白芯片技术检测96例危重病患者和30例健康对照者的血清蛋白质组变化.测量LGT蛋白质组的丰度值,结合急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)分值,分析LGT蛋白质组对危重病患者预后评估的临床意义.结果危重病患者血清指纹图谱存在LGT蛋白质组表达谱,APACHE Ⅱ评分≥15分组(35例)LGT蛋白质组丰度[(9.26±7.51)%]明显高于APACHE Ⅱ评分＜15分组(61例)的丰度[(4.19±4.07)%],且两组丰度明显高于健康对照组[(1.52±0.47)%],差异有统计学意义(均P＜0.01);患者LGT蛋白质组丰度与APACHE Ⅱ评分呈明显正相关(r=0.317,P=0.002).死亡组(23例)LGT蛋白质组丰度[(10.14±9.23)%]明显高于存活组(73例)的丰度[(5.83±3.57)%,P＜0.01];且LGT蛋白质组丰度≥5%组的病死率[68.0%(17/25)]明显高于丰度＜5%组[8.5%(6/71),P＜0.01].用LGT蛋白质组预测预后的阳性预测率为68.0%,阴性预测率为91.5%;假阳性率为32.0%,假阴性率为8.5%.结论 LGT蛋白质组与病情的严重程度及预后密切相关,可能成为危重病患者预后评估的重要指标;结合APACHE Ⅱ评分系统可为临床早期评估危重病患者预后提供更可靠的依据.
목적 탐토위중병환자혈청LGT단백질조적변화규률,분석기대질병예후평고적림상의의.방법 채용단백심편기술검측96례위중병환자화30례건강대조자적혈청단백질조변화.측량LGT단백질조적봉도치,결합급성생이학여만성건강상황평분계통Ⅱ(APACHE Ⅱ)분치,분석LGT단백질조대위중병환자예후평고적림상의의.결과 위중병환자혈청지문도보존재LGT단백질조표체보,APACHE Ⅱ평분≥15분조(35례)LGT단백질조봉도[(9.26±7.51)%]명현고우APACHE Ⅱ평분＜15분조(61례)적봉도[(4.19±4.07)%],차량조봉도명현고우건강대조조[(1.52±0.47)%],차이유통계학의의(균P＜0.01);환자LGT단백질조봉도여APACHE Ⅱ평분정명현정상관(r=0.317,P=0.002).사망조(23례)LGT단백질조봉도[(10.14±9.23)%]명현고우존활조(73례)적봉도[(5.83±3.57)%,P＜0.01];차LGT단백질조봉도≥5%조적병사솔[68.0%(17/25)]명현고우봉도＜5%조[8.5%(6/71),P＜0.01].용LGT단백질조예측예후적양성예측솔위68.0%,음성예측솔위91.5%;가양성솔위32.0%,가음성솔위8.5%.결론 LGT단백질조여병정적엄중정도급예후밀절상관,가능성위위중병환자예후평고적중요지표;결합APACHE Ⅱ평분계통가위림상조기평고위중병환자예후제공경가고적의거.
Objective To investigate the expression of serum lost goodwill target(LGT)proteome,and to analyze its clinical significance in evaluating prognosis of patient with critical illness on the basis of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score. Methods The serum samples were collected from 96 patients with critical illness and 30 healthy volunteers as healthy control. The expression of serum LGT proteome was detected by surface-enhanced laser desorption/ionization-time of flight-mass spectrometry(SELDI-TOF-MS)protein-chip technology. The abundance value of LGT proteome in patients at admission was measured, and at the same time APACHE Ⅱ score was estimated, in order to analyze its clinical significance in patients with critical illness. Results The amount of LGT proteome in APACHE Ⅱ≥15 group[n= 35,(9.26 ± 7. 51)%]was significantly higher than that of APACHE Ⅱ＜ 15 group[n= 61,(4. 19 ± 4.07)%], and the LGT proteome amount in both groups was significantly higher than that of the healthy control group[(1.52± 0.47)%, both P＜0.01]. Spearman correlation analysis showed that there was significant positive correlation between the abundance of LGT proteome and the APACHE Ⅱ score (r=0. 317, P=0. 002). The abundance of LGT proteome in death group[n=23,(10. 14±9. 23)%]was significantly higher than that in survival group[n=73,(5. 83±3.57)%, P＜0. 01]. The fatality rate of the LGT proteome group with average abundance exceeding 5%[68.0%(17/25)]was significantly higher than that of the LGT proteome group with average abundance lower than 5%[8.5%(6/71), P＜0.01].According to the LGT proteome abundance to evaluate the prognosis of the patients, the positive predict rate was 68.0 %, the negative predict rate was 91.5 %, the false positive rate was 32. 0%, the false negative rate was 8.5%. Conclusion The LGT proteome was intimately correlated with the severity degree of disease condition and prognosis in patients with critical illness. The determination of LGT proteome combined with APACHE Ⅱ score evaluation can probably be an important indicator in evaluating the prognosis of patient with critical illness. Further research on LGT proteome is warranted to facilitate the prognostication and clinical decision-making.