Serum Concentration And Clinical Significance Of Glial Fibrillary Acidic Protein And S100β Protein In Patients With Acute Intracerebral Hemorrhage

Objective:To observe the dynamic changes of serum levels of glial fibrillary acidic protein(GFAP)and S100βprotein and explore their correlations with the severity and outcome in the patients with intracerebral hemorrhage(ICH).Methods:A total of 33 patients were involved in this study.GFAP and S100βprotein concentration in the serum of 33 patients on admission(＜12hours)and at 3 day,7 day,15 day and 30 normal control were determined by enzyme-lineked immunosorbent assay(ELISA);Clinical(Fugl—Meyer appraise)and radiological information(ICH and perihematomal edema volumes)were collected at baseline and follow-up visits.Functional outcome was assessed with modified Barthel index(MBI) at 15 day and modified Rankin scale(MRS)at 3 months.relation between dynamic changes of GFAP and S100βand degree of neurologic impaiment(FMA),the volume of ICH and perihematomal edema(PE)volumes and outcome were analysisd.Results:(1)The serum levels of GFAP in the patients at various time were higher than the control group(P＜0.05).It were rised on admission and reached the peak at 3 day,then decreased at follow 7,15 day in which The serum levels of GFAP were higher than the control group(P＜0.05),so is S100βprotein.(2)The GFAP level of patients at each point has negative correlation with FMA(r=-0.5413,P＜0.01; r=-0.7847,P＜0.01;r=-0.4382,P＜0.05;r=-0.4056,P＜0.05);The S100βprotein level of patients at each point has negative correlation with FMA(r=-0.4612,P＜0.05; r=-0.7167,P＜0.01;r=-0.3958,P＜0.05;r=-0.3563,P＜0.05).(3-4)The GFAP level at each point was distinguished associated with the volume of ICH (r=0.6024,P＜0.01,r=0.8840,P＜0.01)and PE(r=0.5039,P＜0.01;r=0.5482, P＜0.05),The S100βprotein level was distinguished associated with the volume of ICH(r=0.5149,P＜0.01;r=0.8870,P＜0.01)and PE(r=0.3680,P＜0.05; r=0.4992,P＜0.01).(5)The serum level of GFAP in more volume group(15.48±3.54) ng/L was higher than less group(5.82±2.73)ng/L(P＜0.01)and the serum level of S100βprotein in more volume group(0.2660±0.0674)ug/L was higher than less group(0.0729±0.0247)ug/L(P＜0.01).(6)The serum levels of GFAP at each point has negative correlation with MBI at 15 day(r=-0.4412,P＜0.05;r=-0.5298,P＜0.01; r=-0.5353,P＜0.01;r=-0.5061,P＜0.05)and the serum levels of S100βprotein at each point has negative correlation with MBI(r=-0.4023,P＜0.05;r=-0.4586,P＜0.01;r =-0.6053,P＜0.01;r=-0.4317,P＜0.05).(7)Logistic analysis showed GFAP as the independent predictor for unfavorable outcome at 90 days(OR,15;95%CI,2.9 to 76.3)and S100βas the independent predictor for unfavorable outcome at 90 days(OR, 3.7;95%CI,2.0 to 13.2).(8)Using receiver operating characteristic curve analysis,a cut off point of 4.2 ng/L of GFAP provided a sensitivity of 0.84 and a specificity of 0.64 and a cut off point of 0.243 ug/L of S100βprovided a sensitivity of 0.78 and a specificity of 0.66 for the identification of outcome.Conclusion:Increased GFAP and S100βprotein level were found after acute ICH, which reached the peak at 3 day and then decreased.They have negative correlation with degree of pathogenetic and outcome.They may be biomarkers reflecting degree of pathogenetic and predicting outcome in the patients with intracerebral hemorrhage.