标题：严重颅脑损伤后血清 GFAP、UCH-L1与 CT表现及预后的关系

      作者：乔柏林，韩娜，刘艳丛，韩鹏，王启华    (唐山市丰润区人民医院脑一科，河北 唐山 064000)

      卷次： 2016年27卷22期

      【摘要】 目的 研究严重颅脑损伤后血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基端水解酶(UCH-L1)水平变化，并观察其与预后的关系，为临床诊疗提供依据。方法 选取2014年12月至2016年2月我院脑一科收治的严重颅脑损伤患者130例为观察组，另选取同期健康体检者60例为对照组，检测两组受检者血清中GFAP和UCH-L1水平，对观察组患者进行CT检查，应用格拉斯哥预后(GOS)评分评估观察组患者的预后，比较两组受检者的GFAP和UCH-L1水平，并评价观察组患者GFAP和UCH-L1水平与CT表现和GOS评分的关系。结果 观察组患者的GFAP和UCH-L1水平分别为(5.31±0.18) μg/L、(3.98±0.24) μg/L，明显高于对照组的(0.11±0.01) μg/L、(0.08±0.02) μg/L，差异均具有统计学意义(P<0.05)；CT表现局限性损害患者GFAP水平为(7.09±0.42) μg/L，明显高于弥漫性患者的(2.32±0.08) μg/L，UCH-L1水平为(1.02±0.02) μg/L，明显低于弥漫性患者的(4.98±0.05) μg/L，差异均具有统计学意义(P<0.05)；GOS评分预后不良者GFAP和UCH-L1水平分别为(8.27±0.42) μg/L、(6.57±2.53) μg/L，明显高于GOS评分预后良好者的(2.64±0.09) μg/L、(2.08±0.05) μg/L，差异均具有统计学意义(P<0.05)；相关分析显示，GFAP和UCH-L1水平与GOS评分呈负相关(r=0.783，0.802，P<0.05)。结论 严重颅脑损伤患者CT表现不同时GFAP和UCH-L1水平也存在差异，且GFAP和UCH-L1对患者预后具有预测作用。
      【关键词】 严重颅脑损伤；神经胶质纤维酸性蛋白；泛素羧基端水解酶；预后
      【中图分类号】 R651.1+5 【文献标识码】 A 【文章编号】 1003—6350（2016）22—3663—03

Relationship between serum GFAP, UCH-L1 and CT manifestations with prognosis of severe brain injury.
QIAOBai-lin, HAN Na, LIU Yan-cong, HAN Peng, WANG Qi-hua. Department of Brain I, Fengrun District People's Hospital ofTangshan City, Tangshan 064000, Hebei, CHINA
【Abstract】 Objective To study the changes of serum glial fiber acidic protein (GFAP) and ubiquitin carboxylterminal enzyme (UCH-L1) in serum after severe brain injury, and to observe the relationship between the prognosis andtheir performance, so as to provide basis for clinical diagnosis and treatment. Methods A total of 130 cases of patientswith severe traumatic brain injury, who admitted to Department of Brain Ⅰ of Fengrun District People's Hospital ofTangshan City from December 2014 to February 2016, were selected as the study group, and at the same time, 60 casesof healthy physical examination were selected as the control group. The serum GFAP and UCH-L1 levels in the twogroups were detected. CT examination was performed in the study group. The prognosis of patients in the study groupwas evaluated by the Glasgow prognostic score (GOS), and the relationship of the level of GFAP and UCH-L1 with CTand GOS score were analyzed. Results The levels of GFAP and UCH-L1 in the study group were significantly higherthan those in the control group, (5.31±0.18) vs (0.11±0.01), (3.98±0.24) vs (0.08±0.02), respectively (P<0.05); GFAPlevels of CT in the limited damage patients were significantly higher than that in the diffuse patients, (7.09±0.42) vs·论 著·doi:10.3969/j.issn.1003-6350.2016.22.018