重型颅脑损伤后脑脊液内GFAP蛋白的变化及其与颅内压的相关性研究  

Changes of GFAP protein in cerebrospinal fluid after severe craniocerebral injury and its correlation with intracranial pressure

作　　者：涂杳然[1] 牛凡[1] 洪德全 TU Yao-ran;NIU Fan;HONG De-quan(Trauma Center,the First Hospital of Nanehang City,Jiangxi Province,Nanehang 330008,China)

机构地区：[1]南昌市第一医院急创中心,江西南昌330008

出　　处：《中国当代医药》2018年第28期39-41,共3页China Modern Medicine

基　　金：江西省南昌市指导性科技计划项目(洪科发计字[2016]96号第15项)

摘　　要：目的探讨重型颅脑损伤后脑脊液内血清胶质纤维酸性蛋白(GFAP)的变化及与颅内压的相关性,为提高重型颅脑损伤的诊治水平提供依据。方法选取我院2016年10月~2017年8月收治的42例高重型颅脑损伤患者为实验组,另选同期健康体检者或志愿者42例为对照组。分别于伤后的6、12、24、48、72 h提取脑脊液标本,检测其GFAP蛋白水平,同时连续监测患者颅内压变化,并与GFAP蛋白水平、颅内压进行比较,同时分析研究组伤后各时间点GFAP蛋白的变化水平与颅内压的相关性。结果 (1)实验组各时间点脑脊液GFAP蛋白水平均明显高于对照组(P<0.05);实验组脑伤后24 h GFAP达到峰值,并随着时间逐渐下降;(2)实验组伤后颅内压即刻出现升高趋势,且各时间点颅内压均明显高于对照组(P<0.05);实验组颅内压峰值发生在伤后48.48 h颅内压仍然维持在较高水平状态;(3)实验组颅内压与脑脊液GFAP蛋白均呈现升高趋势,且成正相关(r=6.483,P<0.05)。结论重型颅脑损伤后脑脊液内GFAP蛋白及颅内压升高,早期它们的变化趋势是一致的,检测脑脊液GFAP蛋白及颅内压可以为临床诊断,把握病情演化,治疗提供参考依据。Objective To investigate the changes of serum glial fibrillary acidic protein （GFAP） in cerebrospinal fluid （CSF） after severe craniocerebral injury and its correlation with intracranial pressure, so as to provide a basis for im- proving the diagnosis and treatment of severe craniocerebral injury. Methods A total of 42 cases of severe craniocere- bral injury treated in our hospital from October 2016 to August 2017 were selected as the experimental group, and 42 cases of healthy physical examination or volunteers were selected as the control group. The cerebrospinal fluid samples were extracted from 6, 12, 24, 48 and 72 h after injury, and the level of GFAP protein was detected, and the changes of intracranial pressure were monitored continuously, and the level of GFAP protein and intracranial pressure were com- pared with that of the intracranial pressure. At the same time, the correlation between the change of GFAP protein and the intracranial pressure at each time point after injury in the study group were analyzed. Results ①The level of GFAP protein in cerebrospinal fluid in the experimental group was significantly higher than that of the control group （P〈0.05）, and the 24 h reached the peak value in the experimental group after brain injury and decreased with the time. ②The intracranial pressure increased immediately after injury in the experimental group, and the intracranial pressure at all time points was significantly higher than that of the control group （P〈0.05）. The peak of intracranial pressure in the ex- perimental group occurred at 48 h after injury, and the intracranial pressure remained at a high level after 48 h. ③The intracranial pressure and cerebrospinal fluid GFAP protein in the experimental group showed an upward trend and a positive correlation （r=6.483, P〈0.05）. Conclusion After severe craniocerebral injury, GFAP protein and intracranial pressure in cerebrospinal fluid are elevated, and their changes in early stage are consistent. The detection of GFAP prote

关 键 词：颅脑损伤 脑脊液 胶质纤维酸性蛋白 颅内压 

分 类 号：R651.15[医药卫生—外科学]