创伤性颅脑损伤后血清GFAP蛋白的变化与伤情及预后的Meta分析  

Correlation of GFAP expression with injury severity and prognosis following traumatic brain injury:Meta analysis

作　　者：王昊[1] 杨华江[1] 周椿[1] 杨东虹[1] 赵辉[2] 徐伦山[1] 许民辉[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经外科,重庆400042 [2]第三军医大学大坪医院野战外科研究所第四研究室,重庆400042

出　　处：《创伤外科杂志》2017年第6期405-410,共6页Journal of Traumatic Surgery

基　　金：国家自然科学基金资助项目(31470913)

摘　　要：目的评价血清胶质纤维酸性蛋白(GFAP)表达水平与创伤性颅脑损伤(TBI)伤情及预后的关系。方法通过计算机检索PubMed、EBSCO、Web of Science、Springer、Science director、ACS、ProQuest、Taylor&Francis、中国学术期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据知识服务平台。设定文献纳入和排除标准,提取文献资料中死亡风险优势比(odds ratio,OR)作为主要评价指标,采用Revman 5.0软件进行Meta分析,探讨创伤性颅脑损伤(TBI)与GFAP的关系。结果符合条件的文献有16篇,其中正常对照组患者753例,TBI患者1 149例。Meta分析结果显示:(1)GFAP表达量与Marshall CT分级(OR=-5.44,95%CI=-7.07^-3.82,P<0.01)、TBI程度(OR=-3.47,95%CI=-3.52^-3.41,P<0.01)、TBI类型(OR=3.19,95%CI=2.51~3.88,P<0.01)、格拉斯哥预后评分(GOS评分)(OR=2.78,95%CI=2.76~2.81,P<0.01)、生存与否(OR=-1.66,95%CI=-2.35^-0.97,P<0.01)有关。(2)GFAP表达与时间间隔具有相关性,与72h表达量(OR=-0.09,95%CI=-0.46~0.28,P<0.01)和7d表达量(OR=2.51,95%CI=2.03~3.05,P<0.01)均相关。结论 GFAP蛋白表达水平与TBI的伤情严重程度和预后均具有相关性。Objective To investigate the relationship between the expression of glial fibrillary acidic protein （ GFAP ） and the traumatic condition and prognosis of traumatic brain injury （ TBI ）. Methods Reference databases including PubMed, EBSCO, Web of Science, Springer, Science Director, ACS, ProQuest, Taylor ＆ Francis, CNKI, VIP and Wanfang were searched, the inclusion criteria and exclusion criteria of literature were set. The outcome was measured using the odds ratio （ OR ） and inclusion literature was analyzed by Revman 5. 0 software. Re- suits Sixteen references were qualified,with 753 cases in the control group and 1149 cases in the TBI group. Meta analysis results showed that： （ 1 ） The GFAP expression was related to Marshall CT classification （ OR = - 5.44, 95% CI = - 7.07 -- 3.82 ,P 〈 0. 01 ） ,TBI degree （ OR = - 3.47,95% CI = - - 3.52 - - 3.41, P 〈 0. 01 ）, type of TBI （OR =3. 19,95%CI =2. 51 -3.88,P〈0. 01 ） ,GOS score （OR =2. 78,95%CI =2. 76 -2. 81,P 〈0. 01）, and survived or not （ OR = - 1.66,95% CI = - 2. 35 - - 0. 97, P 〈 0.01 ）. （ 2） The GFAP expression was related with time lapse,including 72h （ OR = - 0.09,95% CI = - 0. 46 - 0. 28,P 〈 0. 01 ） ,7d （ OR = 2. 51,95 % CI = 2. 03 3.05, P 〈 0. 01 ）. Conclusion The expression of GFAP was relevant with the traumatic condition and prognosis of TBI.

关 键 词：颅脑损伤 蛋白 META分析 

分 类 号：R651.15[医药卫生—外科学]