GFAP and S100B in the acute phase of mild traumatic brain injury
GFAP and S100B in the acute phase of mild traumatic brain injury
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DOI：
10.1212/wnl.0b013e318253d5c7
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发表时间：
2012-05-01
期刊：
影响因子：
9.9
通讯作者：
van der Naalt, J.
中科院分区：
文献类型：
--
作者：
Metting, Z.;Wilczak, N.;van der Naalt, J.
目的：生物标志物胶质细胞酸性蛋白（GFAP）和S100 B越来越多地用作严重创伤性脑损伤（TBI）的预后工具。轻度TBI的数据很少。本研究旨在分析GFAP和S100 B对轻度TBI预后的预测价值及其与影像学的关系。收集的数据包括损伤严重程度、患者特征、入院CT和损伤后3个月MRI。结果：伤后6个月GFAP平均值为0.25 μ g/L（SD 1.08），S100B平均值为0.54 μ g/L（SD 1.18）。在63%的患者中，GFAP不可识别。CT异常患者GFAP水平（1.20 μ g/L，SD 2.65）高于CT正常患者（0.05 μ g/L，SD 0.17，p <0.05）。在MRI上有轴索损伤的患者中，GFAP也较高（0.65 μ g/L，SD 0.91 vs 0.07 μ g/L，SD 0.2，p <0.05）。与完全RTW相比，不完全RTW患者的GFAP增加（0.69 μ g/L，SD 2.11 vs 0.12 μ g/L，SD 0.38，p <0.05）。S100 B与结局或影像学研究无关。在多变量分析GFAP是不预测的结果确定GOSE和RTW。结论：GFAP与影像学检查和结果（确定RTW）之间的关系，发现在对比S100 B。由于GFAP的阳性预测值在这类TBI患者中有限，因此该生物标志物不适合预测个体患者的结果。神经病学（R）2012; 78：1428 - 1433
Objective: The biomarkers glial fibrillary acid protein (GFAP) and S100B are increasingly used as prognostic tools in severe traumatic brain injury (TBI). Data for mild TBI are scarce. This study aims to analyze the predictive value of GFAP and S100B for outcome in mild TBI and the relation with imaging.Methods: In 94 patients biomarkers were determined directly after admission. Collected data included injury severity, patient characteristics, admission CT, and MRI 3 months postinjury. Six months postinjury outcome was determined with Glasgow Outcome Scale Extended (GOSE) and return to work (RTW).Results: Mean GFAP was 0.25 mu g/L (SD 1.08) and S100B 0.54 mu g/L (SD 1.18). In 63% GFAP was not discernible. GFAP was increased in patients with an abnormal CT (1.20 mu g/L, SD 2.65) compared to normal CT (0.05 mu g/L, SD 0.17, p < 0.05). Also in patients with axonal injury on MRI GFAP was higher (0.65 mu g/L, SD 0.91 vs 0.07 mu g/L, SD 0.2, p < 0.05). GFAP was increased in patients with incomplete RTW compared to complete RTW (0.69 mu g/L, SD 2.11 vs 0.12 mu g/L, SD 0.38, p < 0.05). S100B was not related to outcome or imaging studies. In multivariate analysis GFAP was not predictive for outcome determined by GOSE and RTW.Conclusions: A relation between GFAP with imaging studies and outcome (determined by RTW) was found in contrast to S100B. As the positive predictive value of GFAP is limited in this category of TBI patients, this biomarker is not suitable for prediction of individual patient outcome. Neurology (R) 2012;78:1428-1433