颅脑损伤患者血清GFAP含量变化及其临床意义

Change and clinical significance of serum GFAP in patients with traumatic brain injury

目的探讨颅脑损伤患者血清中胶质纤维酸性蛋白(GFAP)的变化及其临床意义,并与S-100B蛋白和神经元特异性烯醇化酶(NSE)进行比较。方法采用酶联免疫吸附法(ELISA)检测97例颅脑损伤患者损伤后12h和30名健康人的血清GFAP、S-100B和NSE水平,分析其与格拉斯哥昏迷评分及预后的关系。结果颅脑损伤患者在伤后12h血清GFAP水平显著高于对照组(t=2.03,P<0.05);血清GFAP水平与48h的格拉斯哥昏迷评分及6个月后格拉斯哥预后评分呈负相关(r=-0.54、-0.21,P均<0.05);应用ROC曲线分析,血清GFAP曲线下面积显著大于S-100B和NSE(P均<0.05)。结论血清GFAP检测可作为判断颅脑损伤早期病情的指标之一,其敏感性优于常规指标S-100B和NSE。

Objective To explore the changes and significance of serum glial fibrillary acidic protein（GFAP）,S-100B and neuron-specific enolase（NSE） in patients with traumatic brain injury.Methods Serum GFAP,S-100B and NSE levels of 30 healthy persons and 97 patients with traumatic brain injury were detected by ELISA method,and the relationship with GCS and prognosis were analyzed.Results The GFAP level of patients was higher than that of the control group（t = 2.03,P0.05）;the GFAP level had negative correlation with 48 hours GCS and 6 month GOS（r=-0.54,-0.21,P0.05） ;using receiver operating characteristic curve（ROC） analysis,the areas under of ROC of GFAP was more than other biomarkers（P0.05）.Conclusions GFAP level examinations can be used for diagnosis of early brain injury and predict prognosis,which was more sensitive than S-100B or NSE.