血浆GFAP与NfL水平评估创伤性脑损伤患者疾病严重程度及预后的价值  

Value of plasma GFAP and NfL levels in evaluating the severity and prognosis of traumatic brain injury patients

作　　者：何晓峰 邓文静[2] HE Xiaofeng;DENG Wenjing(The First Clinical College of Zhengzhou University,Zhengzhou 450052,China;The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一临床医学院,河南郑州450052 [2]郑州大学第一附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2024年第7期826-830,共5页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金项目(编号:82101385);河南省自然科学基金项目(编号:212300410262)。

摘　　要：目的探讨血浆GFAP、NfL水平评估创伤性脑损伤(TBI)患者疾病严重程度及预后的价值。方法纳入40例TBI患者(创伤组),16例健康对照者(对照组),应用Simoa HD-X平台检测血浆GFAP、NfL水平,格拉斯哥预后扩展量表(GOSE)评估患者预后,使用lnGFAP、lnNfL和平均指标(lnGFAP与lnNfL均值)进行分析。结果创伤组血浆lnGFAP及lnNfL值较对照组显著升高,差异有统计学意义(P<0.001)。血浆lnGFAP及lnNfL值在重度TBI患者中显著增高(P<0.001),在轻度与中度TBI患者中无统计学差异(P>0.05)。lnGFAP、lnNfL和平均指标与GCS评分(rs=-0.723、-0.791、-0.838)、GOSE评分(rs=-0.671、-0.704、-0.771)呈负相关,对伤后6个月不良预后(AUC=0.83、0.83、0.89)和病死率(AUC=0.91、0.91、0.94)有预测价值。结论TBI患者急性期血浆GFAP、NfL水平有助于疾病早期病情判断和预后评估,平均指标的效果优于单个指标。Objective To investigate the value of plasma GFAP and NfL levels in evaluating disease severity and prognosis in patients with traumatic brain injury(TBI).Methods Forty TBI patients(trauma group)and 16 healthy controls(control group)were selected for inclusion in the study.Using the Simoa HD-X platform to detect the concentrations of GFAP and NfL in patients’plasma,the Glasgow outcome scale-extended(GOSE)to assess patient prognosis.Date analysis used lnGFAP,lnNfL,and average indicator(mean of lnGFAP and lnNfL).Results The plasma lnGFAP and lnNfL levels in the trauma group were significantly higher than those in the control group,and the difference was statistically significant(P<0.001).The plasma lnGFAP and lnNfL levels were significantly increased in patients with severe TBI(P<0.001),and there was no statistical difference between mild and moderate TBI patients.LnGFAP,lnNfL,and average indicator were negative correlated with GCS score(rs=-0.723,-0.791,-0.838)and GOSE score(rs=-0.671,-0.704,-0.771).They had predictive ability of adverse prognosis(AUC=0.83,0.83,0.89)and mortality(AUC=0.91,0.91,0.94)at 6 months after injury.Conclusion The levels of plasma GFAP and NfL in TBI patients during the acute phase are helpful for early disease diagnosis and prognosis evaluation.The effectiveness of average indicator is better than that of individual indicators.

关 键 词：创伤性脑损伤 生物标记物 纤维酸性蛋白 神经丝蛋白 病情判断 预后评估 

分 类 号：R651.15[医药卫生—外科学]