摘要
目的研究脑卒中患者血清胶质纤维酸性蛋白(GFAP)含量的动态变化和临床意义,探讨其在缺血性脑卒中(IS)与出血性脑卒中(ICH)的差异和病理机制。方法选择发病1 2 h内入院的脑卒中患者65例,依据头颅CT或MRI分为IS组37例和ICH组28例,同期健康体检者30例作为对照组。采用酶联免疫吸附试验方法 ,检测发病<12 h,3、14 d时血清GFAP含量。结果除外IS组第3天,IS组和ICH组患者发病<12 h,3、14d血清GFAP含量较对照组明显升高(P<0.05,P<0.01);IS组患者发病<12 h,3、14 d血清GFAP含量明显低于ICH组,差异有统计学意义(P<0.01);依据ROC曲线不同临界值,GFAP对IS诊断敏感性为81.1%,特异性为46.7%;对ICH诊断敏感性为78.6%,特异性为80.0%;血清GFAP含量呈现不同的动态变化趋势;血清GFAP含量与神经功能缺损评定、瘫痪程度、出血量、日常生活活动能力密切相关(P<0.05,P<0.01)。结论脑卒中患者血清GFAP含量明显升高,IS与ICH患者存在明显差异,可以作为脑卒中的辅助检查指标。
Objective To study dynamic change and clinical significance of serum concentration of glial fibrillary acidic protein（GFAP） in patients with stroke, and to explore the difference and pathological mechanisms of GFAP in ischemic stroke （IS） and intracerebral hemorrhage （ICH）. Methods Sixty-five stroke patients admitted within 12 h of symptom onset were included. They were divided into 37 cases of IS and 28 cases of ICH according to the image displayed in CT or MRI. The serum level of GFAP was measured in all patients using ELISA test at 〈12 h,3 d and 14 d after symptom onset. Results The median GFAP serum concentration in IS and ICH patients was significantly higher compared with the controls besides 3d＇s （P 〈 0.05,P 〈 0.01）; The GFAP concentration of IS group,which was lower than that of ICH group at 〈12 h,3 d and 14 d with obvious statistical difference （P 〈 0.01）. According to the different cutoff values in a receiver operating characteristic curve analysis,the diagnostic sensitivity and specificity of GFAP were 81.1% and 46.7% in IS,and 78.6% and 80.0% in ICH. Serum GFAP level displayed different dynamic changes in IS and ICH at 〈12 h,3 d,14 d time points. GFAP serum levels were significantly correlated with the MESSS, paralysis degree, haematoma volume, and Barthel index （P 〈0.05,P 〈 0.01）. Conclusions GFAP serum concentration is significantly raised in stroke patients and is obviously different between IS and ICH groups. It can be an adjuvant index for stroke.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2011年第3期238-241,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
天津市科技成果(20100756)
