The Study Of The UCH-L1,GFAP And MMP-9’s Clinical Significance For Hypertensive Intracerebral Hemorrhage

Objective:To investigate the clinical significance of brain injury biomarkers —CH-L1, GFAP and MMP-9, for the hypertensive intracerebral hemorrhage. Create a specific laboratory examination-"Three items for evaluating the severity of hypertensive intracerebral hemorrhage ", and explore it’s clinical practical values.Methods:Forty patients with hypertensive intracerebral hemorrhage, who were in No.2 Department of Neurosurgery of the Second Hospital Affiliated to Lanzhou University from 2013 November to 2015 January, were selected randomly. At the same time, five people from the physical examination center were selected as control group. In the experimental group,2mL venous blood was collected within 24 hours after the hypertensive intracerebral hemorrhage had happened. And in the control group,2mL venous blood was got from volunteers without breakfast. Under the condition of 4℃, the blood specimen had been centrifuged on the speed of 3000r/min for 15min, collecting supernatant, which was divided into 3 EP tubes equally and saved in -80℃ refrigerator for following examination. The brain injury biomarkers were measured by ELISA. On 24 hours of the onset, ICHscore and GCS were finished; according to the head CT, the volume of intracerebral hematoma was counted, and the absolute volume of perihematomal edema was calculated on the basis of the head CT which was done on the seventh day after the onset. According to the serum concentration of UCH-L1, GFAP and MMP-9, "Three items for evaluating the severity of hypertensive cerebral hemorrhage " scores were counted. The mRS, assessing patients self-care ability, was carried out by phone after 60 days. SPSS 19.0 was used for statistical analysis, measurement data was introduced as x±s, differences between groups were compared by t test, the diagnostic critical value was determined by ROC curve analysis, the differences have statistical significance with P< 0.05.Results:1 In the cerebral hemorrhage group, the average serum concentrations of UCH-L1, GFAP and MMP-9 were 95.10±21.66pg/mL,13.79±8.23ng/mL and 184.30±61.74ng/mL. In the control group, they were 50.04±11.55pg/mL,3.47±0.40ng/mL and 43.07±4.44ng/mL. The differences of the three brain injury biomarkers between groups have statistical significance (P<0.05)2 In the ICHscore≤2 group, the average serum concentrations of UCH-L1, GFAP and MMP-9 were 82.42±12.37pg/mL,9.21±4.18ng/mL and 152.60±47.25ng/mL. In the ICHscore≥3 group, they were 116.20±16.70pg/mL,21.43±7.66ng/mL and 239.50±35.24ng/mL. The differences of the three brain injury biomarkers between groups have statistical significance (P<0.05).3 In the GCS13-15 group, the average serum concentrations of UCH-L1, GFAP and MMP-9 were 77.29±10.16pg/mL,7.12±1.74ng/mL and 130.3+33.61ng/mL. In the GCS9-12 group, they were 101.60±12.76pg/mL,16.32±5.30ng/mL and 216.10±24.74ng/mL. In the GCS3-8 group, they were 123.80±14.77pg/mL,24.38±7.88 ng/mL and 254.90±34.03ng/mL. The differences of the three brain injury biomarkers among groups have statistical significance (P<0.05).4 In the group with the volume of hematoma≤20mL, the average serum concentrations of UCH-L1, GFAP and MMP-9 were 73.53±7.86pg/mL,6.24±1.06ng/mL and 114.90±24.88ng/mL. In the hematoma volume 20-40mL group, they were 92.02±9.02pg/mL,11.35±2.09ng/mL and 186.30± 17.42 ng/mL. In the hematoma volume 40-60mL group, they were 104.90±4.85pg/mL, 17.51±3.07ng/mL and 225.10±15.50ng/mL. In the hematoma volume> 60mL group, 133.30±11.76pg/mL,29.48±4.23 ng/mL and 275.70±16.06ng/mL. The differences of the three brain injury biomarkers among groups have statistical significance (P<0.05).5 In the group with the absolutely volume of perihematomal edema≤30mL, the average serum concentrations of UCH-L1, GFAP and MMP-9 were 77.29±10.16pg/mL,7.12±1.74 ng/mL and 130.30±33.61ng/mL. In the absolutely perihematomal edema volume> 30mL group, they were 109.70±17.12pg/mL,19.25±7.34ng/mL and 230.20±33.62ng/mL. The differences of the three brain injury biomarkers between groups have statistical significance (P<0.05)6 In the good prognosis group, the average serum concentrations of UCH-L1, GFAP and MMP-9 were 81.54±11.46pg/mL,8.38±2.84 ng/mL and 146.00±41.79ng/mL. In the poor prognosis group, they were 113.40±18.49pg/mL,21.11±7.41ng/mL and 238.20±35.56ng/mL. The differences of the three brain injury biomarkers between groups have statistical significance (P< 0.05).7 According to "three items for evaluating the severity of hypertensive cerebral hemorrhage "scores, patients were divided into three groups. The differences of GCS score and hematoma volume among all group have statistical significance (P<0.05). And other norms have none (P >0.05).Conclusion:1 UCH-L1, GFAP, MMP-9 can reflect the condition of brain tissue damage caused by hypertensive cerebral hemorrhage.2 "Three items for evaluating the severity of hypertensive cerebral hemorrhage" has great potentially clinical significance for hypertensive cerebral hemorrhage, which needs further validation by large sample sturdy.