| Objective:To observe the dynamic changes of serum levels of glial fibrillary acidic protein (GFAP) and IL-6 and explore their correlations with the severity and outcome in the patients with intracerebral hemorrhage (ICH)Methods:A total of 56 patients with intracerebral haemorrhagia(ICH) of the first 24h and 50 healthy control(normal control group) were enrolled in this study. The serum GFAP and IL-6 concentration of the both groups was determined by enzyme-lineked immunosorbent assay(ELISA),and the pheral blood was collected from the patiests on admission(<24hours) when normal control was collected on medical examination day. The relation between GFAP and IL-6 concentration and degree of neurologic impaiment (NIHSS) on day 1,day 2 and day 7, respectively and serum concentration of GFAP and IL-6 was also anaylysisd,as well as the volume of ICH and perihematomal edema volumes (PHE) by CT and clinical outcome. with modified Barthel index(MBI) at one month and modified Rankin scale(MRS) at 3 months。SPSS 12.0 was used to analysis the data collected,when P<0.05 confirmed significantly.Results:(1) The serum levels of GFAP and IL-6 in the patients within 24h were significantly higher than the control group (P<0.05). The GFAP protein level of the patients within 24h has positive correlation with NIHSS (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 IL-6 protein level of the patients within 24h has negative correlation with NIHSS (r=0.2612,P>0.05; r=0.1167,P>0.05; r=0.2958,P>0.05; r=0.0563,P>0.05). There were 12 patients displayed funtion deterioration of nervous system in 48h after hemorrhage, the GFAP level of whoes were significantly higher than patients who did not display such deterioration[(13.05±2.78) ng/L VS (6.18±1.65) ng/L,P<0.05)]. Among the 12 patients, the IL-6 level were significantly higher than the remain patients, (59.94±21.78) pg/L VS (54.18±19.32) pg/L,P>0.05).(2) The GFAP level within 24h was distinguished associated with the volume of ICH (r=0.4920, P<0.01), analysised by Sperman rank correlation analysis, and volume of PE also showed a positive correlation with the IL-6 level (r=0.4952,P<0.01), While the IL-6 level was distinguished associated with the volume of PE (r=0.4720,P<0.01), analysised by Sperman rank correlation analysis.(3) Levels of serum GFAP, IL-6 in patients with cerebral hemorrage in ventricles were (15.43±2.41) ng/L and (94.5±12.1) ng/L independently, which is significantly higher than levels in patients with cerebral lobe hemorrage (7.54±2.12 ng/L P<0.05), (67.25±13.8, P<0.05) and basal ganglia hemorrage (5.24±1.67, P<0.0), (41.3.5±9.9, P<0.01).(4) Serum level of GFAP protein was positive associated with the score assessed by improved Ranbin scale (r=0.8032,P<0.01). However, serum level of IL-6 failed to show an correlation with the score assessed by improved Ranbin scale (r=0.4071,P> 0.05).Logistic analysis showed GFAP and IL-6 as the independent predictor for early prognosi, when age, higher blood pressure, glucose,NIHSS, the volume of ICH and perihematomal edema volume,concentrion of GFAP were considered as varible, while the socre by improved Ranbin scale was considered as dependent variable(OR=15; 95%CI,3.1～79.6).Conclusion:Increased GFAP and IL-6 protein level were found after acute ICH within 24h. Both of them showed a positive correlation with the volume of hematoma and PE. The serum level of GFAP in patient with ICH have positive correlation with degree of pathogenetic and outcome, while the level of IL-6 failed to show any correleation with degree of pathogenetic and outcome. The serum GFAP levels of patients with cerebral hemorrage showed a positive correlation with the NIHSS scores at each time point, however, IL-6 failed to show this correlation. So serum level of GFAP may be biomarkers reflecting degree of pathogenetic and predicting outcome in the patients with intracerebral hemorrhage.
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