Neuronal and glial markers are differently associated with computed tomography findings and outcome in patients with severe traumatic brain injury: a case control study.
Neuronal and glial markers are differently associated with computed tomography findings and outcome in patients with severe traumatic brain injury: a case control study.
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DOI：
10.1186/cc10286
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发表时间：
2011-06-24
期刊：
影响因子：
--
通讯作者：
Hayes RL
中科院分区：
文献类型：
--
作者：
Mondello S;Papa L;Buki A;Bullock MR;Czeiter E;Tortella FC;Wang KK;Hayes RL
几项研究的作者研究了严重创伤性脑损伤 (TBI) 后急性期的生物标志物和计算机断层扫描 (CT) 结果。然而，神经影像学评估的结构损伤与生物标志物之间的相关性尚未阐明。本研究的目的是探讨严重 TBI 后血清中神经元（泛素羧基末端水解酶 L1 [UCH-L1]）和神经胶质（胶质纤维酸性蛋白 [GFAP]）生物标志物水平、神经放射学结果和结果之间的关系。该研究招募了来自四个神经创伤中心的患者。在入院时以及此后每 6 小时采集一次 UCH-L1 和 GFAP 血清样本。受伤后 24 小时内进行了大脑 CT 扫描。出院时和 6 个月时通过格拉斯哥结果量表 (GOS) 评估结果。 81 名严重 TBI 患者和 167 名对照者入组。与对照组相比，TBI 患者的 UCH-L1 和 GFAP 平均血清水平较高 (p < 0.001)。 UCH-L1 和 GFAP 血清水平与格拉斯哥昏迷量表 (GCS) 和 CT 结果显着相关。肿块性损伤患者的 GFAP 水平高于弥漫性损伤患者（2.95 ± 0.48 ng/ml 对比 0.74 ± 0.11 ng/ml），而弥散性损伤患者的 UCH-L1 水平较高（1.55 ± 0.18 ng/ml 对比 1.21 ± 0.15 ng/ml，p 分别为 0.0031 和 0.0103）。多变量逻辑回归显示 UCH-L1 是出院时死亡的唯一独立预测因子 [调整后的比值比 2.95； 95% 置信区间，1.46-5.97]，但 UCH-L1 和 GFAP 水平强烈预测损伤后 6 个月的死亡。神经影像学检测到的结构变化与生物标志物之间的关系表明，每种生物标志物可能反映不同的损伤途径。这些结果表明，与单独通过神经影像学获得的结果相比，蛋白质生物标志物可以更好地表征处于特定类型细胞损伤风险中的受试者，并提供有关严重 TBI 后损伤严重程度和结果的有价值的信息。
Authors of several studies have studied biomarkers and computed tomography (CT) findings in the acute phase after severe traumatic brain injury (TBI). However, the correlation between structural damage as assessed by neuroimaging and biomarkers has not been elucidated. The aim of this study was to investigate the relationships among neuronal (Ubiquitin carboxy-terminal hydrolase L1 [UCH-L1]) and glial (glial fibrillary acidic protein [GFAP]) biomarker levels in serum, neuroradiological findings and outcomes after severe TBI. The study recruited patients from four neurotrauma centers. Serum samples for UCH-L1 and GFAP were obtained at the time of hospital admission and every 6 hours thereafter. CT scans of the brain were obtained within 24hrs of injury. Outcome was assessed by Glasgow Outcome Scale (GOS) at discharge and at 6 months. 81 severe TBI patients and 167 controls were enrolled. The mean serum levels of UCH-L1 and GFAP were higher (p < 0.001) in TBI patients compared to controls. UCH-L1 and GFAP serum levels correlated significantly with Glasgow Coma Scale (GCS) and CT findings. GFAP levels were higher in patients with mass lesions than in those with diffuse injury (2.95 ± 0.48 ng/ml versus 0.74 ± 0.11 ng/ml) while UCH-L1 levels were higher in patients with diffuse injury (1.55 ± 0.18 ng/ml versus 1.21 ± 0.15 ng/ml, p = 0.0031 and 0.0103, respectively). A multivariate logistic regression showed that UCH-L1 was the only independent predictor of death at discharge [adjusted odds ratios 2.95; 95% confidence interval, 1.46-5.97], but both UCH-L1 and GFAP levels strongly predicted death 6 months post-injury. Relationships between structural changes detected by neuroimaging and biomarkers indicate each biomarker may reflect a different injury pathway. These results suggest that protein biomarkers could provide better characterization of subjects at risk for specific types of cellular damage than that obtained with neuroimaging alone, as well as provide valuable information about injury severity and outcome after severe TBI.
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影响因子：
4.1
作者：
LOBATO, RD;CORDOBES, F;LAMAS, E
通讯作者：
LAMAS, E
DOI：
10.1097/01.ta.0000108998.48026.c3
发表时间：
2004-11-01
影响因子：
--
作者：
Pelinka, LE;Kroepfl, A;Raabe, A
通讯作者：
Raabe, A
影响因子：
4.8
作者：
Maas, AIR;Hukkelhoven, CWPM;Steyerberg, EW
通讯作者：
Steyerberg, EW
影响因子：
9.9
作者：
Vos, PE;Lamers, KJB;Verbeek, MM
通讯作者：
Verbeek, MM
影响因子：
4.2
作者：
DIETRICH, WD;ALONSO, O;HALLEY, M
通讯作者：
HALLEY, M