急性轻、中型颅脑损伤患者血清胶质纤维酸性蛋白水平变化及其临床意义

Change in serum levels of glial fibrillary acidic protein and its clinical significance in patients with mild and moderate traumatic brain injury

目的探讨血清胶质纤维酸性蛋白(GFAP)水平与急性轻中、型颅脑损伤患者伤情的关系。方法选择2010年10月至2012年10月收治的急性颅脑损伤患者120例(颅脑损伤组),伤后4 h时内测定血清GFAP浓度;并与同期体检中心健康志愿者30例和急诊科就诊的四肢外伤患者(无头部外伤)25例血清GFAP水平进行比较。结果颅脑损伤患者血清GFAP水平显著高于健康志愿者[(1.42±0.24)ng/L;P<0.05]和四肢外伤患者[(1.38±0.29)ng/L;(P<0.05)],而后两组之间无统计学差异(P>0.05)。中型颅脑损伤患者血清GFAP水平[(1.75±0.27)ng/L;P<0.05]显著高于轻型颅脑损伤患者[(1.63±0.19)ng/L;P<0.05]。头颅CT检查阳性颅脑损伤患者血清GFAP水平[(1.79±0.23)ng/L]显著高于阴性患者[(1.57±0.21)ng/L;P<0.05)]。手术治疗颅脑损伤患者血清GFAP水平[(1.77±0.25)ng/L]显著高于保守治疗患者[(1.60±0.23)ng/L;P<0.05]。结论血清GFAP可以作为早期评估急性轻、中型颅脑损伤患者病情的一个有价值的指标。

Objective To investigate the change in the serum levels of glial fibrillary acidic protein （GFAP） and its relationship with the severity of mild and moderate traumatic brain injury （TBI） in the patients with TBI. Methods The venous blood was drawn and the serum levels of GFAP were determined by the electrochemiluminescence immunoassay 4 hours after TBI in 120 patients with TBI （GCS, 9 to 15 points）, 30 healthy volunteers and 25 trauma patients without TBI. The serum levels of GFAP were compared among all the groups. Results The serum level of GFAP [（1.66＋0.22） ng/L] was significantly higher in the patient with TBI than those [（1.4±0.24） ng/L and （1.38±0.29） ng/L] in healthy volunteers and trauma patients without TBI （P〈0.05）. The serum level of GFAP [（1.79±0.23） ng/L] was significantly higher in 41 patients with lesions shown by CT than that [（1.57±0.21） ng/L] in 79 patients without lesions shown by CT （P〈 0.05）. The serum level of GFAP [（1.77±0.25） ng/L] was significantly higher in 27 patients who needed neurosurgical treatment than that [（1.60±0.23） ng/L] in 93 patients who did not need neurosurgical treatment （P〈0.05）. Conclusion The present study suggested that serum level of GFAP may be helpful to evaluating severity of mild and moderate TBI.