The Clinical Usage To Detect GFAP And NSE

Objective: nerve biochemical detection provide a kind of effective methodto judge the clinical prognosis to head injury patiens,the study on thenerve-biochemical marker has appeal to the eye of researchers recently,thecommon objective is finding the acute.non-invasive index that can reflect thescope and prognosis of central nerve system.people have found somebiochemical marker that can judge the injury limit and prognosis through thestudy of blood and CSF.at the same time,they found some biochemical markerseven surpass CT and MRI et al imageology scopy in earlier period.such markersinclude some proteins,enzyme, neurotransmitter,cytokines and neurotransmitteret al. Neuro specific enolase is a kind of index needing detedted when the headinjury happened. glial fibrillary acidic protein is a new biochemical markeralso.we want to definite the usage of such two markers on the diagnosis andprognosis of head injury through detecting the changes oftheir concentration inperipherial blood of head injury patients.detecting the expression level of headtissue to those patients needing operation,definite if the expression level of headtissue concord to the level in peripherial blood 。at the same time ,the sensitivityand specificity to judge the prognosis of head injury were definited.Methods:all objects recruited were examed by head CT to testify contusionand laceration of brain, scored with GCS system,all those severe combinedinjury;auto-immune disease;malignant tumor;heametology disease and severeinfection were removed. Operation group and non-operation group were dividedaccording if operation was undertaked, dividing the patients into gently;meddleand severe groups according the head injury extent,the peripherial blood wasdetected in the patients without operation at 4h,6h,8h,12h,16h,24h,48h afterin-patient,but at 2h,4h,8h,24h before and after operation to those patientsundertaking the operation.other detection such as the expression of GFAP,NSEin cerebral tissue was executed to those operation patients .at the same time,MAP,ICP,CCP need to be monitored to severe head injury.calculate therelationship between such markers and the MAP , ICP , CCP,prognosis.hyperthermy ,acute Cardiogenic oedema pulmonum, hyperglykemia originatedfrom diabetes. Gastrorrhagia from ulcer, senile dementia, Inflammation of thecentral nervous system, epilepsy, migraine and dementia praecox patients wererecruited as pathology control group.healthy objects recruited as health controlgroup.Resluts:the NSE,GFAP concentration in peripherial blood after head injuryshow significant difference with health control group (p<0.05).the peakconcentration of NSE is 12h but GFAP is 48h after head injury to thoseno-operation patients.the rapid increasing of NSE in peripherial blood is earlierand more speicific than GFAP in head injury patients,the concentration ofNSE increasing continuely to peak near death in severe head injury patients.Theconcentration of GFAP and NSE decreases gradually after operation,the velocityof NSE is faster than GFAP,those patients who decreasing of such indexesisnot obviously indicate the bad prognosis. the concentration of GFAP inperipherial blood show significant difference with fever,edema of lung,highhyperglycaemia, gastrorrhagia patients(p<0.05). the concentration of GFAP inperipherial blood of senile dementia, Inflammation of the central nervous system,epilepsy, migraine and dementia praecox patients show no difference withhealth objects(p>0.05),but NSE has obviously distinction with healthobjects.these discovery indicates that GFAP is more specificity than NSE onmeasure head injury.the concentraion of peripherial blood ,the expression ofbrain tissue of GFAP and NSE are higher in ICP<25 mmHg, MAP<60 mmHg,CCP<60 mmHg patients than ICP≥25 mmHg, MAP≥60 mmHg, CCP≥60mmHg patients, The concentration of NSE and GFAP show obviouslyrelationship with prognosis ( r=0.915, p<0.05 ) ,the more high of Theconcentration of NSE and GFAP when hospital admission;the more bad of theprognosis.conclusions:the GFAP and NSE can both assit to diagnosis head injury andjudge the condition of prognosis.the such markers in peripherial blood accordsto the expression of brain tissue.NSE is more sensitive and GFAP is morespecific though different time spot observation after injury.