肺结核蛋白指纹图谱诊断技术研究

目的探索应用蛋白质组学技术于肺结核诊断。方法从本院临床肺结核病例中，选择痰检测结核分枝杆菌培养阳性、阴性肺结核患者共130名，以健康者65名为对照，进行血清蛋白指纹图谱检测，分析其相关蛋白峰值并进行统计学处理。结果130例活动性肺结核患者，与65名正常人群血清蛋白质质谱数据的比较，5个蛋白峰(5335、8048、11683、11700 、11526m/z)有差异，有统计学意义(P<0.01)。该诊断模型判别的总准确率为92.3%（180/195）,特异度100%(65/65),灵敏度88.5%(115/130)。130例活动性肺结核患者中，菌（+）65例，质谱仪检测结果峰值为：5335 m/z 24例，11683 m/z 16例，8048 m/z 14例，11700m/z5例，占90.8%（59/65）;菌（ ）65例，峰值为：8048 m/z 20例，5335 m/z 14例，11526 m/z 8例，11683 m/z 7例，11700 m/z 6例，占84.6%（55/65）。结论血清蛋白质指纹图谱技术简便、快速，标本用量少，是筛选结核病特异性标志物的有效手段，有望成为活动性肺结核的早期辅助诊断指标。

Identification of diagnosis markers for pulmonary tuberculosis by proteomic fingerprinting

The objective was to study the diagnosis method of active pulmonary tuberculosis using protein fingerprinting technology.A sample of 130 sputum-bacteriologically positive and negative patients with active pulmonary tuberculosis and 65 healthy individuals as control were selected from clinically diagnosed cases of Mycobacterium tuberculosis in the hospital to conducted protein fingerprinting test,and the associated protein peak values were then examined using statistic analysis.Results showed that five protein peaks（5335,8048,11683,11700,and 11526m/z）increased significantly in all 130 active pulmonary tuberculosis patients compared to the 65 control individuals（P0.01）.This diagnostic model showed a diagnostic accuracy of 92.3%（180/195）,specificity of 100%（65/65）,and sensitivity of 88.5%（115/130）respectively.In the 65 sputum-bacteriological positive cases,24 with protein peak at 5335 m/z,16 at 11683 m/z,14 at 8048 m/z,and 5 at 11700 m/z;in the 65 sputum-bacteriological negative cases,20 with protein peak at 8048 m/z,14 at 5335 m/z,8 at 11526 m/z,7 at 11683 m/z,and 6 at 11700 m/z.It＇s indicated that serum protein fingerprinting technology is fast,simple,and consumes a relatively small amount of samples.As a result,it is an effective method for identifying the unique markers of pulmonary tuberculosis and could become a standard in early diagnose.