Diagnostic Value of Serum Levels of GFAP, pNF-H, and NSE Compared With Clinical Findings in Severity Assessment of Human Traumatic Spinal Cord Injury
Diagnostic Value of Serum Levels of GFAP, pNF-H, and NSE Compared With Clinical Findings in Severity Assessment of Human Traumatic Spinal Cord Injury
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DOI：
10.1097/brs.0000000000000654
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发表时间：
2015-07-15
期刊：
影响因子：
3
通讯作者：
Jorjani, Masoumeh
中科院分区：
文献类型：
--
作者：
Ahadi, Reza;Khodagholi, Fariba;Jorjani, Masoumeh
研究设计：一项分析性队列研究。目的：本研究旨在根据血清中磷酸化形式的神经丝重亚基（pNF-H）、神经元特异性烯醇化酶（NSE）和胶质细胞酸性蛋白（GFAP）水平评估创伤性脊髓损伤（SCI）的严重程度，这些指标是轴突、神经细胞体和胶质细胞损伤标志物，背景资料概述先前的研究已经报道了pNF-H、NSE和GFAP的血清水平升高作为检测动物创伤性SCI的生物标志物。然而，在这项研究中，这些生物标志物进行了研究，在人类和延长水平的timing.Methods。这项研究包括35例SCI患者的平均年龄为36.5岁。所有患者均采用美国脊柱损伤协会损伤量表进行评估，随后进行检查，包括X线摄影和脊柱计算机断层扫描，以确定损伤程度。采用酶联免疫吸附法（ELISA）检测血清NSE、pNF-H和GFAP水平。结果：SCI患者血清GFAP水平明显高于对照组。脊髓损伤患者伤后24和48小时血清pNF-H和NSE水平显著高于对照组。血清GFAP水平是适当的估计SCI的严重程度，在第一个24小时后injure.Conclusion.Our研究结果表明，血清GFAP，NSE，和pNF-H的水平升高可用于诊断和SCI严重程度的创伤患者。在伤后48小时内，血清pNF-H、NSE和GFAP水平的估计，结合神经功能测试，可以在脊柱计算机断层扫描和手术或保守干预之前预测SCI的存在和严重程度。证据等级：2
Study Design.An analytical cohort study.Objective.This study aimed to evaluate severity of traumatic spinal cord injury (SCI) based on the serum levels of phosphorylated form of heavy subunit of neurofilament (pNF-H), neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP), which are axonal, neural cell body, and glial cell injury markers, respectively.Summary of Background Data.Prior studies have reported elevated serum levels of pNF-H, NSE, and GFAP as biomarkers for the detection of traumatic SCI in animals. However, in this study, these biomarkers were studied in humans and with an extended level of timing.Methods.The study included 35 patients with SCI with a mean age of 36.5 years. All patients were evaluated using the American Spinal Injury Association Impairment Scale, followed by examinations including radiography and spinal computed tomography for determining the injury level. Serum levels of NSE, pNF-H, and GFAP were determined using enzyme-linked immunosorbent assay.Results.The mean serum level of GFAP was significantly higher in patients with SCI than in the control group. Mean serum levels of pNF-H and NSE were significantly higher during 24 and 48 hours after injury in patients with SCI than in the control group. The serum level of GFAP was appropriate for estimating the severity of SCI in the first 24 hours after injury.Conclusion.Our findings suggest that increased serum levels of GFAP, NSE, and pNF-H can be used for the diagnosis and degree of SCI severity in trauma patients. During 48 hours after injury, estimation of serum levels of pNF-H, NSE, and GFAP, combined with neurological testing, could predict the presence of SCI and severity prior to spinal computed tomography and surgical or conservative interventions.Level of Evidence: 2