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目的通过分析妊娠期高血压疾病患者血清蛋白指纹图谱的变化,筛选并建立妊娠期高血压疾病血清标志物诊断模型。方法应用表面增强激光解析离子化飞行时间质谱(SELDI-TOF-MS)技术分析25例妊娠期高血压疾病患者(研究组)和30例年龄、孕次、产次相匹配的正常足月孕妇(对照组)终止妊娠前的血清蛋白,获得 IMAC3-Cu 蛋白芯片表达图谱。用 Biomarker Wizard 和Biomarker Pattern 软件分析并建立蛋白指纹图谱诊断模型。盲法分析验证该诊断模型。结果在相对分子质量2000～50 000范围内,有10个蛋白质峰差异有统计学意义(P<0.01)。分析、筛选出相对分子质量为39 837、6196、15 529、43 248和22 292的5个差异蛋白,作为妊娠期高血压疾病的诊断模型。应用该模型诊断研究组25例患者全部被正确检出,其敏感性为100%(25/25);对照组30例孕妇中有27例被正确排除,其余3例被误诊为妊娠期高血压疾病,特异性为90%(27/30)。阳性预测值为89%(25/28),阴性预测值为100%(27/27)。盲法验证该模型的敏感性为75%,特异性为75%。结论妊娠期高血压疾病患者血清中有多种异常表达的蛋白质;由5个差异蛋白组成的血清蛋白指纹图谱诊断模型敏感性和特异性均较高,可作为妊娠期高血压疾病的血清标志物诊断模型。
OBJECTIVE: To screen and establish the diagnostic model of serum markers of hypertensive disorder complicating pregnancy by analyzing the changes of serum protein fingerprints in patients with gestational hypertension. Methods Twenty-five pregnant women with pregnancy-induced hypertension (study group) and 30 normal pregnant women with full-term pregnancy matched with normal pregnancy were analyzed by surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) Control group) before termination of pregnancy serum protein to obtain IMAC3-Cu protein chip expression profiles. The Biomarker Wizard and Biomarker Pattern software were used to analyze and establish the protein fingerprinting diagnostic model. Blind analysis validates this diagnostic model. Results There were statistically significant differences in 10 protein peaks between the relative molecular mass of 2000 and 50000 (P <0.01). Five differential proteins with relative molecular masses of 39 837, 6196, 15 529, 43 248 and 22 292 were screened out as a diagnostic model for hypertensive disorder complicating pregnancy. All 25 patients in the study group were correctly detected with a sensitivity of 100% (25/25). In the control group, 27 of the 30 pregnant women were correctly excluded and the remaining 3 were misdiagnosed as gestational hypertension Disease, specificity was 90% (27/30). The positive predictive value was 89% (25/28) and the negative predictive value was 100% (27/27). Blind validation of the model was 75% with a specificity of 75%. Conclusion There are many abnormally expressed proteins in the serum of patients with hypertensive disorder complicating pregnancy. The diagnosis model of serum protein fingerprints composed of five differential proteins has higher sensitivity and specificity and can be used as a serum marker of hypertensive disorder complicating pregnancy Diagnostic model.