综合评估 GFAP 和 UCH-L1 在创伤性脑损伤严重程度评估和预后预测中的作用。

IF 2.2 3区 医学 Q1 MEDICINE, LEGAL
International Journal of Legal Medicine Pub Date : 2024-11-01 Epub Date: 2024-07-08 DOI:10.1007/s00414-024-03287-z
Deepu Mathew, Purvi Purohit, Ashita Gadwal, Abhishek Anil, Raghavendra Kumar Sharma, Vikas P Meshram, Puneet Setia
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引用次数: 0

摘要

研究目的本研究旨在探讨神经胶质纤维酸性蛋白(GFAP)和泛素 C 端水解酶-L1(UCH-L1)作为生物标志物诊断轻度和重度创伤性脑损伤病例和预后的潜力,包括创伤性脑损伤相关死亡病例:这项前瞻性队列研究包括轻度、重度和致命创伤性脑损伤病例各 40 例,以及健康对照组 40 例。分别在受伤后 8 小时和 20 小时采集活体患者的血清样本,检测 UCH-L1 和 GFAP,并在死亡后 6 小时内采集死亡患者的血清样本:结果:在严重和致命创伤性脑损伤患者中均观察到 GFAP 和 UCH-L1 水平升高。这些生物标志物在预测格拉斯哥结果量表扩展版(GOSE)的各种类别方面表现出良好的潜力。结合 GFAP 和 UCH-L1 对创伤性脑损伤病例的诊断和预后具有更高的预测准确性。该研究还根据严重程度和预后确定了 GFAP 和 UCH-L1 的特定临界水平:结论:GFAP 和 UCH-L1 在预测创伤性脑损伤严重程度和功能预后方面表现出中等至良好的鉴别能力。然而,为了提高诊断和预后效用,建议将这些生物标志物结合起来。这种精确的工具可以加强对患者的护理,使治疗计划量身定制,最终降低创伤性脑损伤病例的发病率和死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Integrated Assessment of GFAP and UCH-L1 for their utility in severity assessment and outcome prediction in Traumatic Brain Injury.

Integrated Assessment of GFAP and UCH-L1 for their utility in severity assessment and outcome prediction in Traumatic Brain Injury.

Objectives: This study aimed to explore the potential of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) as biomarkers for diagnosis and prognosis in mild and severe TBI cases, including TBI-related deaths.

Methods: This prospective cohort study includes 40 cases each of mild, severe, fatal TBI cases, and 40 healthy controls. Serum samples were collected from live patients at 8 and 20 h post injury for UCH-L1 and GFAP respectively, and from deceased patients within 6 h of death.

Results: Elevated levels of both GFAP and UCH-L1 were observed in patients with severe and fatal TBI cases. These biomarkers exhibited promising potential for predicting various Glasgow Outcome Scale Extended (GOSE) categories. Combining GFAP and UCH-L1 yielded higher predictive accuracy both for diagnosis and prognosis in TBI cases. The study additionally established specific cut-off levels for GFAP and UCH-L1 stratified according to the severity and prognosis.

Conclusion: GFAP and UCH-L1 individually demonstrated moderate to good discrimination capacity in predicting TBI severity and functional outcomes. However, combining these biomarkers is recommended for improved diagnostic and prognostic utility. This precision tool can enhance patient care, enabling tailored treatment plans, ultimately reducing morbidity and mortality rates in TBI cases.

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来源期刊
CiteScore
5.80
自引率
9.50%
发文量
165
审稿时长
1 months
期刊介绍: The International Journal of Legal Medicine aims to improve the scientific resources used in the elucidation of crime and related forensic applications at a high level of evidential proof. The journal offers review articles tracing development in specific areas, with up-to-date analysis; original articles discussing significant recent research results; case reports describing interesting and exceptional examples; population data; letters to the editors; and technical notes, which appear in a section originally created for rapid publication of data in the dynamic field of DNA analysis.
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