CAJ | 학술논문

目的：利用尿蛋白质组学的新方法，寻找无创性尿液标记物，用以判断临床早期IgA肾病的病理表现。方法对55例早期IgA肾病患者[其中23例病理表现较重（重病理损伤组），32例病理表现较轻（轻病理损伤组）]及14例病理检查完全正常者（正常对照组）的尿液，利用阳离子磁珠分离技术联合基质辅助激光解吸/电离飞行时间质谱法（MALDI- TOF- MS）分析尿液蛋白质质谱。结果建立了3个尿蛋白质/多肽模型。发现潜在的生物标志物及其诊断模型可以区分重病理损伤组和轻病理损伤组，其敏感性和特异性分别为90.48%和96.77%。区分轻病理损伤组和正常对照组的诊断模型，其敏感性和特异性分别为93.55%和85.71%。区分重病理损伤组和正常对照组的诊断模型，其敏感性和特异性分别为100%和92.86%。结论利用磁珠分离结合MALDI- TOF- MS的尿蛋白质组技术在判定早期IgA肾病的病理表现显示出较大潜力。
목적：이용뇨단백질조학적신방법，심조무창성뇨액표기물，용이판단림상조기IgA신병적병리표현。방법대55례조기IgA신병환자[기중23례병리표현교중（중병리손상조），32례병리표현교경（경병리손상조）]급14례병리검사완전정상자（정상대조조）적뇨액，이용양리자자주분리기술연합기질보조격광해흡/전리비행시간질보법（MALDI- TOF- MS）분석뇨액단백질질보。결과건립료3개뇨단백질/다태모형。발현잠재적생물표지물급기진단모형가이구분중병리손상조화경병리손상조，기민감성화특이성분별위90.48%화96.77%。구분경병리손상조화정상대조조적진단모형，기민감성화특이성분별위93.55%화85.71%。구분중병리손상조화정상대조조적진단모형，기민감성화특이성분별위100%화92.86%。결론이용자주분리결합MALDI- TOF- MS적뇨단백질조기술재판정조기IgA신병적병리표현현시출교대잠력。
Objective To search noninvasive methods to identify the pathologic presentation of early IgA nephropathy through urinary proteomic analysis. Methods Total 55 patients with IgA nephropathy were included in this study, with 23 patients having severe pathologic presentation, and the other 32 having mild ones. The control group included 14 normal subjects. The urinary proteomic spectra from those three groups were generated by Matrix- assisted laser desorption/ionization time- of- flight mass spectrometry (MALDI- TOF MS) with weak cationic exchange magnetic beads. Results Three Urine protein/peptide spectra patterns were established. In pattern one, the potential protein biomarkers could identify the severe group and the mild group, the sensitivity was 90.48%and the specificity was 96.77%. In pattern two, the potential protein biomarkers could identify the mild group and the normal group, the sensitivity was 93.55% and the specificity was 85.71%. In pattern three, The potential protein biomarker could identify the severe group and the normal group, the sensitivity was 100%and the specificity was 92.86%. Conclusion Using MALDI- TOF- MS with magnetic beads to detect urine proteomic patterns shows great potential in identifying early IgA nephropathy with different pathological manifestations.