血清蛋白质谱在单纯性室间隔缺损诊断中的应用

目的通过构建血清诊断模型,探讨血清蛋白质谱在诊断单纯性室间隔缺损中的意义。方法采用病例对照研究设计,用CM10蛋白质芯片检测56例单纯性室间隔缺损患儿、85例儿科常见病患儿及23例其他先天性心脏病患儿血清,筛选血清差异蛋白,并构建诊断模型。结果完整模型ROC曲线下面积、预测准确率、灵敏度、特异度、阳性预测值及阴性预测值分别为0.988、95.00%、100.00%、92.42%、87.18%和100.00%,简化模型ROC曲线下面积、预测准确率、灵敏度、特异度、阳性预测值及阴性预测值分别为0.948、94.00%、88.24%、96.97%、93.75%和94.12%。简化模型与完整模型之间预测准确率、灵敏度及特异度比较,差异均无统计学意义（P〉0.05）。结论利用血清蛋白质谱建立的诊断模型能够较好地区分病例与对照,对诊断室间隔缺损具有一定的发展和应用前景。

Diagnosis of isolated ventricular septal defect with serum protein profiling

Objective To explore the value of serum protein profiling for diagnosis of isolated ventricular septal defect(VSD)through developing the serum diagnostic model.Methods Using case-control design,serum samples from 56 isolated VSD patients,85 patients with common pediatric diseases and 23 patients with other congenital heart disease were detected by CM10 ProteinChip for searching the proteins that were significantly different between serum of VSD and control.Diagnostic model was established by Biomarker Patterns software.Results In the intact model and the terse model,the area under receiver operating characteristic curve,accuracy,sensitivity,specificity,positive predictive value and negative predictive value were 0.988 and 0.948,95.00%(95/100)and 94.00%(94/100),100.00%(34/34)and 88.24%(30/34),92.42%(61/66)and 96.97%(64/66),87.18%(34/39)and 93.75%(30/32),and 100.00%(61/61)and 94.12%(64/68),respectively.Between these two models,the accuracy,sensitivity,and specificity were similar(P>0.05).Conclusions The model,constructed by serum protein profiling,has capability of distinguishing the cases from the controls,and shows great potential for diagnosis of VSD.