摘要目的 分析长骨骨折合并重型脑外伤患者的早期血清差异蛋白质表达,寻找其中有促进成骨作用的蛋白质. 方法 随机选取3例重型脑外伤合并下肢长骨骨折的患者为实验组(IF组),匹配与其一般情况相似的单纯重型脑外伤和单纯骨折患者各3例为2个对照组(设为I组和F组).收集各组伤后第3天的血清样本,经纯化与定量后行双向电泳,对实验组比对照组上调表达超过3倍的差异蛋白点进行MALDI-TOF-MS鉴定. 结果 IF组与I组间的差异蛋白点16个,其中5个上调,7个下调,只在IF组表达的蛋白质点4个.IF组与F组间3倍以上的差异蛋白点17个,其中8个上调,7个下调,只在IF组表达的蛋白质点2个.IF组与I组比较的质谱鉴定:鉴定出5种蛋白质,其中只在IF组表达的蛋白点393和423被鉴定为血清转铁蛋白.IF组与F组比较的质谱鉴定:鉴定出4种蛋白质,其中5个上调3倍以上的差异蛋白点都被鉴定为血清转铁蛋白. 结论 以蛋白质组学技术鉴定了骨折合并重型脑外伤与单纯重型脑外伤和单纯骨折患者比较的血清差异蛋白质,初步确定血清转铁蛋白与重型脑外伤促进成骨的机制密切相关.

abstractsObjective To screen the protein that may enhance osteogenesis from the differential serum proteins following long bone fracture (LBF) complicated with severe traumatic brain injury (TBI).Methods Three patients with lower limb LBF complicated with severe TBI were randomly selected as the experimental group (group IF).They were matched with 3 patients with pure severe TBI and 3 patients with pure lower limb LBF fracture as 2 control groups (group I and group F,respectively).All the patients in the 3 groups were similar in general conditions.Their serum samples were collected 3 days after injury in each group.The samples were treated with kits to remove abundant proteins which were purified and quantitatively analyzed.Then 2-DE and MALDI-TOF-MS were conducted to identify the differential protein spots that up-regulated more than 3 times in the experimental group compared with the controls.Results Sixteen protein spots were identified which were differential between group IF and group I.Of these 16 significant spots,4 were only expressed in group IF,5 were up-regulated and 7 down-regulated.Up-regulated spots were identified to 5 unique proteins by MALDI-TOF-MS,and spots 393 and 423 expressed merely in group IF were identified as serotransferrin.Seventeen protein spots were identified which were differential between group IF and group F.Of these 17 significant spots,2 were only expressed in group IF,8 were up-regulated and 7 down-regulated.Up-regulated spots were identified to 4 unique proteins by MALDI-TOF-MS,and 5 significantly increased spots were also identified as serotransferrin.Conclusion It is preliminary ascertained that serotransferrin may be closely related to the mechanism that severe TBI promotes bone-forming.