本文選題：卒中后抑郁癥 + 中風(fēng)�。� 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：研究背景 腦卒中后抑郁是腦卒中患者中最常見(jiàn)的精神疾病并發(fā)癥。卒中后抑郁可以影響到患者腦卒中的治療效果，加重身體殘疾，干擾患者的肢體功能恢復(fù)，增加患者的痛苦，甚至使患者產(chǎn)生自殺觀念。但是，目前卒中后抑郁疾病發(fā)生發(fā)展?jié)撛诘牟±砩頇C(jī)制尚不清楚，在臨床上也沒(méi)有可用于疾病診斷或病情監(jiān)測(cè)的檢測(cè)方法。 目的 本研究旨在運(yùn)用蛋白質(zhì)組學(xué)技術(shù)探討卒中后抑郁疾病患者血漿蛋白質(zhì)組的變化，擬尋找卒中后抑郁患者血漿中異常表達(dá)的蛋白質(zhì)，以期作為客觀診斷卒中后抑郁癥的生物標(biāo)志物，從而為疾病的診斷、預(yù)防、發(fā)病機(jī)制及治療提供依據(jù)。 方法 本研究是對(duì)卒中后抑郁組（15例）、卒中組（15例）和正常對(duì)照組（15例）受試者的血漿蛋白質(zhì)進(jìn)行的一個(gè)比較蛋白質(zhì)組學(xué)研究。首先對(duì)三組受試者的血漿進(jìn)行14種高豐度蛋白的去除，，然后采用iTRAQ同位素標(biāo)記與多維液相色譜分離串聯(lián)質(zhì)譜技術(shù)對(duì)三組受試者的樣本進(jìn)行相對(duì)定量分析和質(zhì)譜鑒定，最后通過(guò)免疫印跡法對(duì)蛋白質(zhì)組學(xué)結(jié)果進(jìn)行進(jìn)一步驗(yàn)證，并對(duì)顯著改變的差異蛋白搜索數(shù)據(jù)庫(kù)進(jìn)行生物信息分析。 結(jié)果 蛋白質(zhì)組學(xué)研究結(jié)果顯示蛋白表達(dá)量顯著改變的蛋白質(zhì)的生物學(xué)功能主要與脂質(zhì)代謝和免疫調(diào)節(jié)有關(guān)，我們選擇了與這些生物功能密切相關(guān)的6個(gè)蛋白（ApoA-IV，ApoC-II，CRP，gelsolin,haptoglobin，LRG）進(jìn)行了Western blotting驗(yàn)證。與卒中組比較，蛋白ApoA-IV的表達(dá)量在卒中后抑郁中顯著上調(diào)，ApoC-II、 LRG和CRP三個(gè)蛋白的表達(dá)量在卒中后抑郁組和正常對(duì)照組中顯著下調(diào)。而gelsolin和haptoglobin這兩個(gè)蛋白的表達(dá)量在三組中都有顯著地改變（gelsolin：正常對(duì)照組卒中后抑郁組卒中組；haptoglobin,卒中組卒中后抑郁組正常對(duì)照組）。 結(jié)論 由于gelsolin和haptoglobin這兩個(gè)蛋白顯示出獨(dú)特的蛋白分層表達(dá)譜，所以gelsolin蛋白表達(dá)量的提高聯(lián)合haptoglobin蛋白表達(dá)量的降低可能可以作為臨床上卒中患者產(chǎn)生抑郁癥狀風(fēng)險(xiǎn)增加的診斷標(biāo)志物
[Abstract]:Research background Post-stroke depression is the most common complication of mental illness in stroke patients. Post-stroke depression can affect the therapeutic effect of stroke, aggravate the body disability, interfere with the recovery of limb function, increase the pain of patients, and even lead to suicidal concept. However, the underlying pathophysiological mechanism of post-stroke depression is not clear, and there is no clinical detection method for disease diagnosis or disease monitoring. Purpose The aim of this study was to investigate the changes of plasma proteome in patients with post-stroke depression by using proteomics techniques, and to seek abnormal expression of proteins in plasma of patients with post-stroke depression. It is expected to be used as a biomarker for the objective diagnosis of post-stroke depression and to provide evidence for the diagnosis, prevention, pathogenesis and treatment of the disease. Method This study was a comparative proteomic study of plasma proteins in 15 patients with post-stroke depression, 15 patients with stroke and 15 normal controls. At first, 14 kinds of high abundance proteins were removed from the plasma of the three groups, and then the samples of the three groups were analyzed quantitatively by iTRAQ isotope labeling and tandem mass spectrometry with multi-dimensional liquid chromatography. Finally, the proteomics results were further verified by Western blotting, and the significant change of differential protein search database was analyzed by bioinformatics. Result The results of proteomics showed that the biological functions of proteins with significant changes in protein expression were mainly related to lipid metabolism and immunomodulation. We selected six proteins, ApoA-IVApoC-II, CRPgelsolinhaptoglobinine (LRGG), which were closely related to these biological functions, to be verified by Western blotting. Compared with stroke group, the expression of protein ApoA-IV significantly up-regulated the expression of ApoC-II, LRG and CRP in post-stroke depression group and normal control group. However, the expression of gelsolin and haptoglobin were significantly changed in the three groups: normal control group, post-stroke depression group, stroke group, normal control group. Conclusion Because the two proteins gelsolin and haptoglobin show unique protein layering expression profile, the increase of gelsolin protein expression combined with the decrease of haptoglobin protein expression may be used as a diagnostic marker for the increased risk of depression in patients with stroke.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3;R749.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 王玉果;;腦卒中偏癱136例的早期護(hù)理干預(yù)[J];中國(guó)誤診學(xué)雜志;2010年35期

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