本文選題：腦膜炎 + SELDI-TOF-MS��； 參考：《吉林大學(xué)》2016年碩士論文

【摘要】：腦膜炎在顱內(nèi)感染疾病中屬常見病、多發(fā)病,以化膿性腦膜炎、結(jié)核性腦膜炎及病毒性腦膜炎為主,共同的臨床表現(xiàn)有頭痛、發(fā)熱、嘔吐甚至驚厥、昏迷等。腦膜炎患者若得不到及時(shí)有效的治療,將會(huì)遺留嚴(yán)重后遺癥甚至死亡。腦膜炎的早期診斷主要依靠臨床表現(xiàn)、影像學(xué)檢查及實(shí)驗(yàn)室檢驗(yàn)。目前腦脊液中直接檢出致病微生物仍是臨床診斷的“金標(biāo)準(zhǔn)”,然而由于傳統(tǒng)病原學(xué)檢測(cè)方法陽(yáng)性率低、耗時(shí)較長(zhǎng),對(duì)腦膜炎類型的早期診斷不具備明顯提示意義,因此急需建立一種高效快速并且敏感特異的診斷方法。目的:應(yīng)用表面增強(qiáng)激光解吸電離飛行時(shí)間質(zhì)譜(surface-enhanced laser desorption ionization time-of-flight mass spectrometry,SELDI-TOF-MS)聯(lián)合蛋白芯片技術(shù)建立三種類型腦膜炎(化膿性腦膜炎、結(jié)核性腦膜炎、病毒性腦膜炎)分型診斷模型。方法:采集62例腦膜炎患者(化膿性腦膜炎16例、結(jié)核性腦膜炎18例、病毒性腦膜炎28例)腦脊液樣本,高速離心后-80℃冰箱保存,樣本在一個(gè)凍融周期內(nèi)同批進(jìn)行分析。采用疏水芯片H50和SELDI-TOF-MS技術(shù)檢測(cè)62例腦脊液樣本,應(yīng)用Biomarker Wizard軟件分析找出差異蛋白峰,用SPSS 16.0軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,應(yīng)用Biomarker Patterns 5.0軟件建立腦膜炎分型診斷模型。結(jié)果:共采集到蛋白峰129個(gè),經(jīng)軟件分析有統(tǒng)計(jì)學(xué)差異的蛋白峰共40個(gè),利用m/z=2176.205、m/z=2326.05、m/z=2436.154、m/z=3399.328、m/z=4125.172、m/z=8927.876、m/z=14675.06七個(gè)差異表達(dá)的蛋白質(zhì)峰成功建立腦膜炎分類決策樹,準(zhǔn)確度為93.548%(58/62)。通過(guò)自身盲法驗(yàn)證模型對(duì)腦膜炎分型的準(zhǔn)確度為93.333%(28/30)。結(jié)論:由7個(gè)差異蛋白峰構(gòu)成的分類決策樹為腦膜炎的分型提供了新的借鑒和參考。
[Abstract]:Meningitis is a common disease in intracranial infection, mainly suppurative meningitis, tuberculous meningitis and viral meningitis. The common clinical manifestations are headache, fever, vomiting and even convulsion, coma and so on. Meningitis patients without timely and effective treatment will leave serious sequelae or even death. The early diagnosis of meningitis depends mainly on clinical manifestations, imaging and laboratory tests. At present, direct detection of pathogenic microorganisms in cerebrospinal fluid (CSF) is still the "gold standard" for clinical diagnosis. However, due to the low positive rate of traditional etiological methods and long time consuming, it has no obvious significance for the early diagnosis of meningitis type. Therefore, it is urgent to establish an efficient, rapid and sensitive diagnostic method. Objective: to establish three types of meningitis (suppurative meningitis, tuberculous meningitis, viral meningitis) by surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) and protein chip technique. Methods: cerebrospinal fluid (CSF) samples were collected from 62 cases of meningitis (16 cases of suppurative meningitis, 18 cases of tuberculous meningitis and 28 cases of viral meningitis). The samples were stored in refrigerator at -80 鈩，

本文編號(hào)：2079377