胶质纤维酸性蛋白和泛素C端水解酶L1在轻中度创伤性脑损伤诊断中的应用

Application of GFAP and UCH-L1 to diagnosis of mild to moderate traumatic brain injury

创伤性脑损伤(TBI)每年会影响全球数千万人,严重威胁人类健康,军人作为特殊群体尤为高发。目前,对于TBI的临床诊断主要依赖于计算机断层扫描(CT)和格拉斯哥昏迷量表(Glasgow Coma Score,GCS)。然而,CT检测的假阳性和患者暴露于电离辐射的高风险及GCS存在较大的主观性等限制了TBI尤其是轻中度TBI(mmTBI)的精准诊断。近年来,胶质纤维酸性蛋白(GFAP)和泛素C端水解酶L1(UCH-L1)正在成为新的TBI诊断血液标志物,其应用越来越广泛。该文梳理了GFAP和UCH-L1的理化性质、功能及其在TBI诊断中与已有标志物相比存在的优势,阐述了其在战时环境下的应用潜力,并展望了TBI快速诊断的研发趋势。

Traumatic brain injury(TBI)yearly endangers millions of people globally and poses a severe threat to human health. The military,as a special group,are vulnerable. The current diagnosis of TBI overwhelmingly depends on the computed tomography(CT)and Glasgow Coma Score(GCS). However,bility accurate diagnosis of TBI is limited by the potential false positive results,and high risk of patients for high-dose ionizing radiation as well as the subjectivity of GCS that depends on patients′ self-description. In recent years,glial fibrillary acidic protein(GFAP)and ubiquitin C-terminal hydrolase L1(UCH-L1)have become blood biomarkers for diagnosis of TBI. This article elaborates the physical and chemical properties and functions of GFAP and UCH-L1 as well as the advantages of TBI diagnosis over other biomarkers.Developments in rapid blood-based diagnosis of TBI are also outlined.