脑出血患者血浆胶质纤维酸性蛋白浓度的变化

Change of Plasma Glial Fibrillary Acidic Protein Concentration in Patients with Ontracerebral Hemorrhage

目的:揭示脑出血患者血浆胶质纤维酸性蛋白浓度的变化,探讨并评价其与疾病预后的相关性。方法:收集脑出血患者和同期健康体检合格者各86例。患者静脉血在脑出血后第1、2、3、5和7d获得,健康体检合格者静脉血在体检时获得,ELISA检测血浆胶质纤维酸性蛋白浓度。结果:脑出血患者血浆胶质纤维酸性蛋白浓度在脑出血后第1d升高,第2d到达高峰,后逐渐下降,均显著高于正常对照组(均P<0.01);与入院时美国国立卫生院神经功能缺损评分呈显著正相关(均P<0.01)。死亡组血浆胶质纤维酸性蛋白浓度均显著高于生存组(均P<0.01)。R0C曲线分析显示,脑出血后第1、2、3、5和7d血浆胶质纤维酸性蛋白浓度预测脑出血1月内死亡均有显著价值(均P<0.01),相比之下,第2d的血浆胶质纤维酸性蛋白浓度对脑出血1月内死亡的预测价值最高。结论:血浆胶质纤维酸性蛋白浓度脑出血后显著升高,与疾病预后显著相关。

Objective In this study, the change of plasma glial fibrillary acidic protein level was determined in patients with intraeerebral hemorrhage and its correlation with disease prognosis was evaluated. Methods Eighty-six eonseeutive patients and 86 healthy controls were enrolled into this study. Plasma glial fibrillary acidic protein eoneentration was measured by enzyme-linked inununosorbent assay. Its Correlation with disease prognosis was analyzed statistically. Results After intraeerebral hemorrhage, plasma glial fibrillary acidic protein level in patients increased at day 1, peaked at day 2, decreased gradually thereafter, and was dramatically higher than that in healthy controls （ all P 〈 0.01 ）. It is significantly associated with national institutes of health stroke scale score （ all P 〈 O. O1 ）. The plasma glial fibrillary acidic protein level in non-survivals was markedly higher than that in survivals （ all P 〈 0.01 ）. A receiver operating characteristic curve analysis showed that plasma glial fibriUary acidic protein level at serial times significantly predicted the 1-month mortality of the patients （all P 〈 0.01 ）. By comparison, plasma glial fibrillary acidic protein level at day 2 showed the highest predictive value for mortality. Conclusion Increased plasma glial fibrillary acidic protein level is found in patients with intracerebral hemorrhage and associated with the poor prognosis.