急性脑出血患者血清胶质纤维酸性蛋白含量及临床意义

目的研究急性脑出血患者血清中胶质纤维酸性蛋白(GFAP)含量及临床意义。方法采用ELISA法检测发病后1 d内脑出血患者(56例,脑出血组)及健康体检者(50例,对照组)血清GFAP含量,分析脑出血患者血清GFAP含量与美国国立卫生研究院脑卒中量表(NIHSS)、血肿体积、血肿周围水肿体积及预后之间的关系。结果脑出血组患者发病第1天血清GFAP含量明显高于对照组,差异有统计学意义(9.41±2.17)ng/L vs (1.17±0.41)ng/L,P0.01];大量出血患者血清GFAP含量明显高于少量出血患者,差异有统计学意义(16.08±3.61)ng/L vs (5.19±2.06)ng/L,P0.01];血清GFAP含量与NIHSS、血肿体积、血肿周围水肿体积及预后呈正相关(r=0.7912,0.4920,0.4870,0.8032,P0.01);ROC曲线分析,以血清GFAP含量4.5 ng/L为标准评估预后,敏感性为0.82,特异性为0.77。结论脑出血后血清GFAP含量增高,在一定程度上反映了患者的病情程度,有助于早期预后的评估。

Serum concentration and clinical significance of glial fibrillary acidic protein in patients with acute intracerebral hemorrhage

Objective To study serum concentration and clinical significance of glial fibrillary acidic protein(GFAP)in patients with acute intracerebral hemorrhage(ICH).Methods A total of 56 patients in first 24 h after ICH(ICH group) and 50 healthy control (normal control group) were enrolled in this study.The serum GFAP concentration of both groups was determined by enzymelinked immunosorbent assay,and the relations of GFAP concentration with degree of neurologic impaiment(NIHSS) ,the volume of ICH and perihematomal edema volume(PHE) and outcome were analysed.Results The GFAP level of patients was higher than that of the control group on first day of ICH(9.41 ±2.17) ng/L vs (1.17 ±0.41) ng/L,P < 0.01].The serum level of GFAP in group with large volume of ICH was higher than that in small volume of ICH group (16.08±3.61) ng/L vs (5.19 ± 2.06) ng/L,P< 0.01].Serum GFAP level had positive correlations with NIHSS score,the volume of ICH,PHE,and prognosis (r = 0.7912,0.4920,0.4870, 0.8032,P < 0.01).In receiver operating characteristic curve analysis,a cutoff point of 4.5 ng/L provided a sensitivity of 0.82 and a specificity of 0.77 for the identification of outcome.Conclusion Increased GFAP level is found after acute ICH,and is related to the severity and outcome in the patients with ICH,which may be helpful to assessment of the prognosis in early stage.