外源性脑损伤患者血清GFAP、PGP9.5表达联合CT诊断的临床价值研究  

Clinical value of serum GFAP and PGP9.5 combined with CT in diagnosis of patients with exogenous brain injury

作　　者：杨宝军 李玲玲 郭丽娟 周楠 王程燕 张香玲 Yang Baojun;Li Lingling;Guo Lijuan;Zhou Nan;Wang Chengyan;Zhang Xiangling(Department of Nuclear Medicine,Jinzhong First People's Hospital,Jinzhong 030600,China)

机构地区：[1]晋中市第一人民医院核医学科,山西晋中030600

出　　处：《中华临床医师杂志（电子版）》2022年第6期541-545,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的研究血清中胶质纤维酸性蛋白(GFAP)、脑特异性蛋白产物(PGP9.5)联合颅脑CT在外源性脑损伤诊断中的临床价值。方法在晋中市第一人民医院2021年5月至2021年10月收治的脑损伤患者中随机选取251例,检测所有患者的血清GFAP、PGP9.5、中枢神经特异性蛋白(S100β)和神经元特异性烯醇化酶(NSE)水平,并对所有患者行颅脑CT检查,对比各项检查结果。结果血清GFAP检测阳性有90例(35.857%),范围在22.723~303.949(124.887±56.396)pg/ml,阴性范围为4.317~21.953(12.996±5.243)pg/ml;血清PGP9.5检测阳性有81例(32.271%),范围为335.180~2321.709(841.986±421.204)pg/ml,阴性范围为30.726~318.667(164.034±34.256)pg/ml;S100β阳性196例(78.09%),范围在0.262~3.520(1.952±0.224)ng/ml,阴性范围为0.021~0.089(0.046±0.008)ng/ml;NSE阳性193例(76.89%),范围在19.085~29.241(25.721±0.512)ng/ml,颅脑CT结果显示有病变者为178例(70.92%),无异常者有73例(29.08%)。轻度、中度、重度三组患者其血清GFAP、PGP9.5、S100β、NSE水平对比差异具有统计学意义(P<0.05)。109例外源性脑损伤病例GFAP阳性结果90例(82.57%),PGP9.5阳性结果81例(74.31%),S100β阳性结果83例(76.15%),NSE阳性结果111例(75.23%)。三种检查联合应用最高,为96.33%。结论在诊断阳性率基本相当的情况下,GFAP和PGP9.5对外源性脑损伤的诊断比S100β和NSE具有更高的特异性,在对外源性脑损伤的诊断中应用颅脑CT联合血清GFAP、PGP9.5检测的诊断准确性更高,更能帮助临床进行后续治疗。Objective To assess the clinical value of serum collagen fibrillary acidic protein(GFAP)and brain specific protein product(PGP9.5)combined with craniocerebral CT in the diagnosis of exogenous brain injury.Methods A total of 251 patients with brain injury admitted to The First People's Hospital of Jinzhong from May 2021 to October 2021 were randomly selected.The levels of serum GFAP,PGP9.5,central nervous specific protein(S100β),and neuron specific enolase(NSE)in all patients were detected,brain CT examination was performed on all patients,and the results were compared.Results Ninety patients(35.857%)were positive for GFAP[range,22.723~303.949 pg/ml;mean,(124.887±56.396)pg/ml],and those who were negative for GFAP had GFAP levels ranging from 4.317~21.953(12.996±5.243)pg/ml;81 patients(32.271%)were positive for PGP9.5[range,335.180~2321.709;mean,(841.986±421.204)pg/ml,and those who were negative for PGP9.5 had PGP9.5 levels ranging from 30.726~318.667(164.034±34.256)pg/ml;196 patients(78.09%)were positive for S100β[range,0.262~3.520 ng/ml;mean,(1.952±0.224)ng/ml],and those who were negative for S100βhad S100βlevels ranging from 0.021~0.089(0.046±0.008)ng/ml;and 193 patients(76.89%)were positive for NSE[range,19.085~29.241 ng/ml;mean,(25.721±0.512)ng/ml].Brain CT showed lesions in 178 cases(70.92%)and no abnormality in 73(29.08%).There were statistically significant differences in serum GFAP,PGP9.5,S100β,and NSE levels among the mild,moderate,and severe groups(P<0.05).Among 109 cases with exogenous brain injury,90(82.57%)were positive for GFAP,81(74.31%)for PGP9.5,83(76.15%)for S100β,and 111(75.23%)for NSE.The diagnostic accuracy of the three tests combined was 96.33%.Conclusion Serum GFAP and PGP9.5 have higher specificity than S100βand NSE in the diagnosis of exogenous brain injury under the condition that the positive rate of diagnosis is basically the same.The application of brain CT combined with serum GFAP and PGP9.5 in the diagnosis of exogenous brain injury has higher diagnostic accuracy and is

关 键 词：血清GFAP 血清PGP9.5 外源性脑损伤 颅脑CT 

分 类 号：R651.15[医药卫生—外科学]