神经胶质原纤维酸性蛋白作为儿童先天性心脏缺陷行心脏手术患者脑损伤的血清神经标志物

Q4 Pharmacology, Toxicology and Pharmaceutics
Lacramioara-Eliza Chiperi, Adina Huţanu
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引用次数: 0

摘要

摘要目的:本研究的目的是评估神经胶质原纤维酸性蛋白(GFAP)作为儿科先天性缺陷(CHD)患者心血管手术干预后短期神经发育迟缓的标志。方法:术前数日及术后4 ~ 6个月采用丹佛发育筛查试验ⅱ量表对入选患者进行筛查。术前和术后24小时采集血样;使用BioVendor的商用试剂盒通过酶联免疫吸附法评估GFAP水平。结果:40例患儿入组,根据外周血氧饱和度分为两组:紫绀组(> 95%)和非紫绀组(>=95%)。我们人群中有63%的人有异常的神经发育结果。两组患者术前语言领域评分差异有统计学意义(p=0.03),术后精细运动领域评分差异有统计学意义(p=0.03)。术后,青紫型冠心病组GFAP值显著增高(p=0.0248)。分析GFAP和NIRS之间的相关性,发现两组之间存在显著差异,非紫绀型冠心病组具有良好的预测模型(受试者操作特征曲线下aria为0.7)。术后GFAP水平升高与神经发育障碍相关(神经发育评分优者平均值为0.66±0.02ng/ml,神经发育评分低者平均值为0.69±0.02ng/ml, p=0.01)。结论:GFAP可作为围手术期NIRS监测记录的早期急性脑损伤的可靠神经标志物,也可作为较低神经发育评分记录的短期神经发育障碍的神经标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Glial fibrillary acidic protein as a serum neuromarker of brain injury in pediatric patients with congenital heart defects undergoing cardiac surgery
Abstract Objective: The aim of this study was to assess glial fibrillary acidic protein (GFAP) as a marker of short-term neurodevelopmental delay in pediatric patients with congenital defects (CHD) after cardiovascular surgical intervention. Methods: Included patients were screened by Denver Developmental Screening Test II scale a few days before and then at 4 to 6 months after the surgical intervention. Blood samples were collected preoperatory and at 24 hours after surgery; GFAP levels were assessed by enzyme-linked immunosorbent assay using commercial kit form BioVendor. Results: Forty children were enrolled and dichotomized into two groups based on peripheric oxygen saturation: cyanotic (<95%) and non-cyanotic (>=95%) group. 63% from our population had an abnormal neurodevelopmental outcome. Significant differences between groups were found in language domain scores preoperatory (p=0.03) and in fine motor domain postoperatory (p=0.03). In the postoperatory period, GFAP had significantly higher values (p=0.0248) in the cyanotic CHD group. Association between GFAP and NIRS were analyzed and significant differences were found in both groups with a good predicting model in the non-cyanotic CHD group (aria under curve of 0.7 for receiver operative characteristic). Higher GFAP levels from the postoperatory period correlated with neurodevelopmental impairment (mean value of: 0.66 ± 0.02ng/ml in those with good neurodevelopmental score, 0.69 ± 0.02ng/ml in those with low neurodevelopmental score, p=0.01). Conclusions: GFAP could be a reliable neuromarker in identifying early acute brain injury documented by NIRS monitorization during perioperatory period and it also could identify short term neurodevelopmental impairment documented by lower neurodevelopmental scores.
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来源期刊
Acta Marisiensis - Seria Medica
Acta Marisiensis - Seria Medica Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)
CiteScore
0.40
自引率
0.00%
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0
审稿时长
24 weeks
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