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

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.