血液中细胞质肌动蛋白-1升高在急性脑梗死早期诊断中的价值

目的 应用iTRAQ技术,探索急性脑梗死早期血液生物标志物。 方法 选取2016年7月—2018年7月就诊浙江省舟山医院的急性脑梗死患者40例,按发病时间分为5组:脑梗死1组(发病<2 h)8例,脑梗死2组(发病2~4 h)8例,脑梗死3组(发病4~6 h)8例,脑梗死4组(发病6~24 h)8例,脑梗死5组(发病24~72 h)8例;另选取3组为:短暂脑缺血性发作组(发病<2 h)和急性脑出血组(发病<2 h)各8例,以及健康对照组8例。应用iTRAQ技术,对各组血清进行检测,筛选出临床上有意义的生物标志物。 结果 ①在脑梗死急性期发现多个差异蛋白质,主要参与165种生物学过程、35种细胞组分、38种分子功能。②这些差异蛋白质主要涉及三类生物代谢途径,包括:补体调节途径、血液凝固途径和细胞信号转导通路;细胞组分包括:细胞外空间、血小板a颗粒、脂蛋白复合体、分泌颗粒;分子功能包括:酶活性、离子类等。③脑梗死特有的生物标志物有细胞质肌动蛋白-1、血清淀粉样蛋白P、P因子、C反应蛋白、血清淀粉样蛋白A1、3-磷酸甘油醛脱氢酶,其中细胞质肌动蛋白-1最具意义。 结论 急性脑梗死2 h内血脑屏障紧密连接损害是一个特征性的变化,这一变化可以有效区分急性脑梗死与短暂脑缺血发作、脑出血。细胞质肌动蛋白-1可能是一种可以用于诊断急性脑梗死的特异性标志物。 

Value of elevated blood cytoplasm actin-1 in early diagnosis of acute cerebral infarction

Objective To explore blood biomarkers in the early stage of acute cerebral infarction using iTRAQ technology. Methods Forty patients with acute cerebral infarction admitted in Zhoushan Hospital of Zhejiang Province from July 2016 to July 2018 were selected and divided into 5 groups according to the onset time: cerebral infarction group 1(onset<2 h), group 2(onset 2 to 4 h), group 3(onset 4 to 6 h), group 4(onset 6 to 24 h), and group 5(onset 24 to 72 h), with 8 cases in each group. There were another 3 groups: transient cerebral ischemic attack group(onset<2 h), acute cerebral hemorrhage group(onset<2 h), and the control group, with 8 cases in each group. The iTRAQ technique was used to detect the serum and screen out clinically significant biomarkers. Results ① Multiple differential proteins were found in the acute phase of cerebral infarction, mainly involved in 165 biological processes, 35 cellular components, and 38 molecular functions. ② These differential proteins mainly involve 3 types of biological metabolic pathways: complement regulation pathway, blood coagulation pathway and cell signal transduction pathway. Cell components included extracellular space, platelet a particle, lipoprotein complex, and secretory granules. Molecular functions included enzyme activity, ionics, etc. ③ The unique biomarkers of cerebral infarction included actin, cytoplasmic 1, serum amyloid P-component, properdin, C-reactive protein, serum amyloid A-1 protein, glyceraldehyde-3-phosphate dehydrogenase. Actin and cytoplasmic 1 were the most meaningful. Conclusion The tight blood-brain barrier tight junction damage within 2 h of acute cerebral infarction is a characteristic change, which can effectively distinguish acute cerebral infarction with transient ischemic attack and cerebral hemorrhage. Actin and cytoplasmic 1 may be a specific marker that can be used for acute cerebral infarction.