【摘要】 目的研究严重颅脑损伤后血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基端水解酶(UCH-L1)水平变化,并观察其与预后的关系,为临床诊疗提供依据。方法选取2014年12月至2016年2月我院脑一科收治的严重颅脑损伤患者130例为观察组,另选取同期健康体检者60例为对照组,检测两组受检者血清中GFAP和UCH-L1水平,对观察组患者进行CT检查,应用格拉斯哥预后(GOS)评分评估观察组患者的预后,比较两组受检者的GFAP和UCH-L1水平,并评价观察组患者GFAP和UCH-L1水平与CT表现和GOS评分的关系。结果观察组患者的GFAP和UCH-L1水平分别为(5.31±0.18)μg/L、(3.98±0.24)μg/L,明显高于对照组的(0.11±0.01)μg/L、(0.08±0.02)μg/L,差异均具有统计学意义(P<0.05);CT表现局限性损害患者GFAP水平为(7.09±0.42)μg/L,明显高于弥漫性患者的(2.32±0.08)μg/L,UCH-L1水平为(1.02±0.02)μg/L,明显低于弥漫性患者的(4.98±0.05)μg/L,差异均具有统计学意义(P<0.05);GOS评分预后不良者GFAP和UCH-L1水平分别为(8.27±0.42)μg/L、(6.57±2.53)μg/L,明显高于GOS评分预后良好者的(2.64±0.09)μg/L、(2.08±0.05)μg/L,差异均具有统计学意义(P<0.05);相关分析显示,GFAP和UCH-L1水平与GOS评分呈负相关(r=0.783,0.802,P<0.05)。结论严重颅脑损伤患者CT表现不同时GFAP和UCH-L1水平也存在差异,且GFAP和UCH-L1对患者预后具有预测作用。更多还原

【Abstract】 Objective To study the changes of serum glial fiber acidic protein(GFAP) and ubiquitin carboxyl terminal enzyme(UCH-L1) in serum after severe brain injury, and to observe the relationship between the prognosis and their performance, so as to provide basis for clinical diagnosis and treatment. Methods A total of 130 cases of patients with severe traumatic brain injury, who admitted to Department of Brain Ⅰ of Fengrun District People’s Hospital of Tangshan City from December 2014 to February 2016, were selected as the study group, and at the same time, 60 cases of healthy physical examination were selected as the control group. The serum GFAP and UCH-L1 levels in the two groups were detected. CT examination was performed in the study group. The prognosis of patients in the study group was evaluated by the Glasgow prognostic score(GOS), and the relationship of the level of GFAP and UCH-L1 with CT and GOS score were analyzed. Results The levels of GFAP and UCH-L1 in the study group were significantly higher than those in the control group,(5.31±0.18) vs(0.11±0.01),(3.98±0.24) vs(0.08±0.02), respectively(P<0.05); GFAP levels of CT in the limited damage patients were significantly higher than that in the diffuse patients,(7.09 ± 0.42) vs(2.32±0.08), P<0.05; UCH-L1 levels in the limited damage patients were significantly lower than that in the diffuse patients,(1.02 ± 0.02) vs(4.98 ± 0.05), P<0.05. The levels of GFAP and UCH-L1 in the poor prognosis(GOS score) patients were significantly higher than those in the good prognosis(GOS score) patients,(8.27 ± 0.42) vs(2.64 ± 0.09),(6.57±2.53) vs(2.08±0.05), respectively(P<0.05). Correlation analysis showed that GFAP and UCH-L1 levels were negatively correlated with GOS score(r=0.783, 0.802, P<0.05). Conclusion When there are differences in GFAP and UCH-L1 levels in the patients with severe brain injury, CT manifestations also exist differences, and GFAP and UCH-L1 can be used to predict the prognosis of the patients.更多还原