脑卒中患者血清胶质纤维酸性蛋白的变化观察  

Observation of change of serum glial fibrillary acidic protein level in patients with acute hemorrhagic stroke

作　　者：梁建伟[1] 崔桂萍[1] 杨萍[1] 张葳[1] 

机构地区：[1]天津市环湖医院检验科,天津300060

出　　处：《检验医学》2011年第11期722-725,共4页Laboratory Medicine

摘　　要：目的测定出血性脑卒中患者血清中胶质纤维酸性蛋白(GFAP)的动态变化,探讨其与神经功能缺损程度评分(MESSS)、预后Barthe1指数(BI)以及脑出血量和瘫痪程度的关系。方法采用酶联免疫吸附试验(ELISA)检测出血性脑卒中患者发病后第1天、第3天和第14天血清GFAP水平。所有患者在相应的时间点进行MESSS评分,并在出院时评价BI。结果患者发病后第1天、第3天和第14天血清GFAP水平分别为(9.22±3.65)、(8.18±3.52)、(8.45±3.77)ng/mL,均显著高于对照组[(4.62±1.56)ng/mL](P<0.01)。第1天和第3天血清GFAP水平分别与相应时间的MESSS评分呈正相关[相关系数(r)=0.696,P<0.01;r=0.352,P<0.05]。第1天和第3天血清GFAP水平分别与相应时间的出血量呈正相关(r=0.520,P<0.01;r=0.440,P<0.05)。而第14天血清GFAP水平与出院时BI呈负相关(r=-0.431,P<0.05)。第1天血清GFAP水平与瘫痪程度呈正相关(r=0.462,P<0.05)。当临界值(Cut-off)为6.021 ng/mL时,ELISA的灵敏度为78.6%,特异度为80.0%。结论出血性脑卒中患者血清GFAP水平显著升高,有望成为出血性脑卒中患者早期病情诊断和预后评估的指标。Objective To determine the dynamic change of serum glial fibrillary acidic protein （GFAP） level in patients with acute hemorrhagic stroke, and investigate the relationships with modified Edinburgh-Scandinavian stroke scale （MESSS） , Barthel index （ BI）, volume of haematoma and degree of paralysis. Methods The serum levels of GFAP in patients with acute hemorrhagic stroke at the 1st d, 3rd d and 14th d were determined by enzyme-linked immunosorbent assay（ELISA）. The status of all patients was evaluated by MESSS at the corresponding time points, and B1 was evaluated at discharge from the hospital. Results For all patients observed, serum GFAP levels at the 1 st d [ （9.22±3.65） ng/mL], 3rd d [ （8.18 ±3.52）ng/mL] and the 14th d [ （8.45 ±3.77）ng/mL] after onset of stroke were higher than those of control group [ （ 4. 62 ± 1. 56 ） ng/mL ] （ P 〈 0. 01 ）. There were signifieant positive correlations between serum GFAP levels with MESSS [coefficient of correlation （r） =0. 696,P 〈0. 01 ;r =0. 352,P 〈 0.05 ] and haematoma volume （ r = 0. 520, P 〈 0. 01 ; r = 0. 440, P 〈 0.05 ） at the 1 st d and the 3rd d, respectively. There was significant negative correlation between GFAP level on the 14th d and BI at discharge （ r = -0.431, P 〈 0.05 ）. There was also significant positive correlation between GFAP level on the 1 st d and paralysis degree （ r = 0. 462, P 〈 0.05 ）. A Cut-off point （6. 021 ng/mL） was found to provide sensitivity （78.6%） and specificity （80.0%） by ELISA for the acute hemorrhagic stroke. Conclusions The serum level of GFAP in patients with acute hemorrhagic stroke increases markedly, and GFAP level may be a useful marker for the early diagnosis and prognosis in patients with acute hemorrhagic stroke.

关 键 词：胶质纤维酸性蛋白 出血性脑卒中 神经功能缺损程度评分 BARTHEL指数 

分 类 号：R446.1[医药卫生—诊断学]