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    GFAP、MBP、S100β蛋白在脓毒症相关性脑病早期识别及病情评估中的临床应用价值

    Clinical application of GFAP, MBP and S100β protein in early identification and severity evaluation of sepsis associated encephalopathy

    • 摘要: 目的 检测脓毒症相关性脑病(SAE)患儿血清中胶质纤维酸性蛋白(GFAP)、髓鞘碱性蛋白(MBP)、S100β蛋白水平的变化,探索其在SAE早期识别及病情严重程度评估中的价值。方法 选择80例脓毒血症患儿为研究对象,其中SAE组40例,脓毒症未合并脑病(non-SAE)组40例,另选择40例健康体检儿童为对照组。对SAE组患儿进行格拉斯哥昏迷评分(GCS)、全面无反应性量表(FOUR)评分。应用ELISA法检测患儿治疗前(入住PICU 1 h内)、治疗后3 d及5 d血清中GFAP、MBP、S100β蛋白水平的变化。结果 SAE组入住PICU 1 h内血清GFAP、MBP、S100β蛋白水平较non-SAE组及对照组明显升高(P<0.05),SAE患儿中昏迷组血清GFAP、MBP、S100β蛋白水平较意识模糊组明显升高(P<0.05);治疗后3 d SAE组血清GFAP、MBP、S100β蛋白水平较non-SAE组高(P<0.05);治疗后5 d SAE组血清中GFAP、MBP、S100β蛋白的水平较non-SAE差异无统计学意义(P>0.05)。GFAP、MBP、S100β蛋白水平与GCS、FOUR呈负相关。结论 血清GFAP、MBP、S100β蛋白有助于SAE的早期识别,对SAE病情严重程度的评估具有积极的意义。

       

      Abstract: Objective To measure the changes in the expression of serum glial fibrillary acidic protein(GFAP),myelin basic protein (MBP),S100β protein in child patients with sepsis associated encephalopathy (SAE),and to explore its clinical application in SAE early recognition and severity evaluation. Methods A total of 80 child patients with sepsis were enrolled. They were divided into two groups (n=40): an SAE group and a non-SAE group. Meanwhile, another 40 children who underwent micro-element examination were selected as a control group. Children in the SAE group were assessed using Glasgow Coma Scale (GCS) and Full Outline of Unresponsiveness (FOUR) Scale.Their changes of serum GFAP, MBP and S100β protein levels were determined by ELISA before treatment (within 1 h after entry into PICU), 3 days and 5 days after treatment. According to the degree of consciousness disorder, patients in the SAE group were divided into two groups: a unconsciousness group and a coma group. Results The SAE group presented remarkable increases in the levels of serum GFAP, MBP and S100β protein, compared with those in the non-SAE group and the control group within 1 hour after entry into PICU (P<0.05). For SAE patients, the coma group produced significantly higher levels of GFAP, MBP and S100β protein in the coma group than those in the unconsciousness group (P<0.05). The levels of GFAP, MBP and S100β protein were higher in the SAE group than those in the non-SAE group 3 days after treatment (P<0.05). There was no statistical difference in the levels of serum GFAP, MBP and S100β protein between the SAE and non-SAE groups 5 days after treatment(P>0.05). The levels of GFAP, MBP and S100β protein were negatively related with GCS and FOUR. Conclusions Serum GFAP, MBP, and S100β protein are helpful in early identification of SAE, and of great use in SAE severity assessment.

       

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