Glial fibrillary acidic protein injury and multiple trauma in serum after traumatic brain
Glial fibrillary acidic protein injury and multiple trauma in serum after traumatic brain
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DOI：
10.1097/01.ta.0000108998.48026.c3
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发表时间：
2004-11-01
影响因子：
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通讯作者：
Raabe, A
中科院分区：
文献类型：
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作者：
Pelinka, LE;Kroepfl, A;Raabe, A
背景。本研究旨在探讨创伤性脑损伤（TBI）后胶质原纤维酸性蛋白（GFAP）是否释放，GFAP与颅脑损伤严重程度及预后是否相关，以及多发创伤无TBI后GFAP是否释放。这项前瞻性研究纳入了114例TBI合并或不合并多发创伤（n = 101）或多发创伤合并TBI （n = 13）的患者，经计算机断层扫描证实。每日GFAP测量从入院时（创伤后< 12小时）开始，并持续到重症监护期间（1-22天）。文献包括根据马歇尔分类的计算机断层扫描分类，基于每日最高颅内压（ICP）、最低脑灌注压（CPP）、最低平均动脉压（MAP）和3个月格拉斯哥结局评分（GOS）。结果:GFAP浓度较低的弥漫性损伤2比弥漫性损伤4 (p < 0.0005)或nonevacuated质量病变大于25毫升(p < 0.005),降低ICP少于25毫米汞柱比ICP 25毫米汞柱以上,较低的CPP CPP的60毫米汞柱或超过60毫米汞柱,低的地图60毫米汞柱或超过地图不到60毫米汞柱(p < 0.0005),并降低率高的1或2比3的非政府组织,4 (p < 0.05),或5 (p < 0.0005)。脑外伤后，非幸存者（n = 39）的GFAP高于幸存者（n = 62） （p < 0.005）。多发创伤后无TBI， GFAP保持正常。结论：研究结果显示GFAP在脑损伤后释放，GFAP与脑损伤严重程度及预后有关，多发创伤无脑损伤后GFAP不释放。
Background. This study aimed to determine whether glial fibrillary acidic protein (GFAP) is released after traumatic brain injury (TBI), whether GFAP is related to brain injury severity and outcome after TBI, and whether GFAP is released after multiple trauma without TBI.Methods:. This prospective study enrolled 114 patients who had TBI with or without multiple trauma (n = 101) or multiple trauma without TBI (n 13), as verified by computerized tomography. Daily GFAP measurement began at admission (< 12 hours after trauma) and continued for the duration of intensive care (1-22 days). Documentation included categorization of computerized tomography according to Marshall classification, based on daily highest intracranial pressure (ICP), lowest cerebral perfusion pressure (CPP), lowest mean arterial pressure (MAP), and 3-month Glasgow Outcome Score (GOS).Results: The GFAP concentration was lower for diffuse injury 2 than for diffuse injury 4 (p < 0.0005) or nonevacuated mass lesions larger than than 25 mL (p < 0.005), lower for a ICP less than 25 mm Hg than for a ICP of 25 mm Hg or more, lower for a CPP of 60 mm Hg or more than for a CPP of 60 mm Hg or less, lower for a MAP of 60 mm Hg or more than for a MAP less than 60 mm Hg (all p < 0.0005), and lower for a GOS of 1 or 2 than for a GOS of 3, 4 (p < 0.05), or 5 (p < 0.0005). After TBI, GFAP was higher in nonsurvivors (n = 39) than in survivors (n = 62) (p < 0.005). After multiple trauma without TBI, GFAP remained normal.Conclusion: The findings showed that GFAP is released after TBI, that GFAP is related to brain injury severity and outcome after TBI, and that GFAP is not released after multiple trauma without brain injury.