创伤性颅脑损伤患者血清LGT蛋白质组动态变化及临床意义探讨

目的探讨创伤性颅脑损伤(TBI)患者血清LGT蛋白质组的动态变化规律,初步分析其在TBI患者病情判断及预后评估中的临床意义。方法将我院收治的69例TBI患者和30名门诊体检者血清用蛋白质指纹仪及WCX2蛋白质芯片检测血清LGT蛋白质组,共检测212人次。在指纹图上,质荷比(M/Z)为相对分子质量11100～11900之间出现一峰簇样指纹标志且蛋白峰值>5%为阳性诊断标准,依据LGT蛋白质组动态变化共分为4组,观察4组中的病死率。计量资料采用SNK-q检验和Wilcoxon秩和检验,计数资料采用χ2检验,相关性分析采用Spearman相关分析。结果入院初LGT蛋白质组丰度在重度颅脑损伤组(13.5±9.3)%]和轻中度颅脑损伤组(5.2±4.9)%]明显高于健康对照组(1.6±0.5)%,P均<0.01];重度颅脑损伤组LGT蛋白质组丰度明显高于轻中度颅脑损伤组(P<0.01),而健康对照组血清中无表达。LGT蛋白质组丰度与预后呈负相关(r=-0.415,P<0.01),死亡组LGT蛋白质组丰度(15.2±12.2)%]明显高于存活组(8.5±6.4)%,P<0.01]。LGT蛋白质组持续阳性组病死率70%,持续阴性组病死率为5%,LGT蛋白质组经治疗由阳性转成阴性组病死率为8%,LGT蛋白质组经治疗由阴性转成阳性组病死率为43%。结论 LGT蛋白质组为TBI患者病理状态下合成的一组蛋白质,与病情严重程度及预后密切相关,对TBI患者病情判断及预后评估可能有重要的临床指导意义。

The clinical significance of changes of the sermn LGT proteome in patients with traumatic brain injury:a pilot study

Objective To investigate the dynamic change of lost goodwill target（LGT） proteome in the serum of patients with traumatic brain injury（TBI）,and make an initiatory analysis of its clinical significance in judging pathogenetic condition and prognosis of TBI patients.Methods The serum samples were collected from 69 TBI patients and 30 healthy volunteers in out-patient clinic.The serum samples were added to a weak cation exchange（WCX2） protein chip and analyzed using surface enhanced laser desorption/ionisation time of flight mass spectrometer（SELDITOF MS） manufactured by Ciphergen Biosystems Inc.（Fermont,CA,USA） in order to screen out LGT proteome expressed in the serum.We established following characteristics as positive diagnosis criterion：having a mass cluster in the range of mass/charge（M/Z） values 11 100-119 000 and the peak value exceeding 5%.According to the dynamic change of LGT proteome,the cases were divided into 4 groups to investigate the individual case fatality rate.SNK-q test,Wilcoxon signed rank test,χ2 test and Spearman correlation analysis were used for statistical analysis.Results The LGT proteome was detected in the serum of TBI patients.The abundance of LGT proteome of severe TBI group （13.5 ± 9.3）%] and light-moderate TBI group （5.2±4.9）%] was significantly higher than that of the controls（1.6±0.5）%,P〈 0.01].The abundance of LGT proteome of severe TBI group was significantly higher than that of light-moderate TBI（P〈0.01）.However,the LGT proteome has not been detected in the serum of the controls.Spearman correlation analysis showed that the abundance of LGT proteome was negative correlation with the prognosis（r=-0.415,P〈0.01）.The average abundance of LGT proteome of death group （15.2±12.2）%] was significantly higher than that of survival group （8.5±6.4）%,P〈0.01].If the LGT proteome were continuous positive,the fatality rate was 70%.If the LGT proteome was continuous negative,the fatality rate was 5%.If the LGT proteome was changed from positive to negative,the fatal ity rate was 8%.If the LGT proteome was changed from negative to positive,the fatality rate was 43%.Conclusion The LGT proteome is produced under pathologic state of TBI patients.The abundance of LGT proteome is intimately associated with pathogenetic condition and prognosis of TBI patients.The LGT proteome maybe plays an important role to predict pathogenetic condition and prognosis of TBI patients.