ELISA检测GFAP的临床意义(2)
通过临床研究可知，出血性脑卒中患者在发病后，GFAP在血清中的含量明显增加，且患者的症状和GFAP水平明显相关，且与预后密切相关；缺血性脑卒中组患者的血清GFAP水平升高，但没有出血性脑卒中组升高显著，与之相对应的是出血性脑卒中组的预后和后遗症情况较缺血性脑卒中组更为严重，原因可能与出血性脑卒中组神经元坏死和脑水肿更为严重，增大了星形胶质细胞的活性，引起星形胶质细胞坏死，大大增加了血脑屏障通透性，从而明显的提高了GFAP在血浆中的含量。所以，对于脑卒中患者，应该检查其GFAP在血清中的变化情况，不单单是有利于急性期脑损伤程度的判断，还可以很好的评估脑卒中的预后。此外，有报道称动脉瘤性蛛网膜下腔出血后，血浆GFAP浓度明显升高，与蛛网膜下腔出血后神经元坏死及神经功能预后不良显著相关[11]。也有报道称，脑外伤后，血浆GFAP水平显著升高[2]，明显高于健康人群。
GFAP作为诊治脑卒中的重要实验室指标具有较高的敏感性和特异性，有助于鉴别缺血性脑卒中和出血性脑卒中[12]；脑梗塞后能早期释放且稳定，可迅速定量测定而且价廉，有助于临床医生诊断和评估脑卒中进展情况，改善病人的预后。
, 百拇医药
[参考文献]
[1] Zhu H，Dahlstr m A. Glial fibrillary acidic protein- expressing cellsin the neurogenic regions in normal and injured adult brains[J].J Neu-rosci Res，2007，85(12)：2783-2792.
[2] Honda M，Tsuruta R，Kaneko T，et al. Serum glial fibrillary acidic protein is a highly specific biomarker for traumatic brain injury in humans compared with S-100B and neuron- specific enolase[J].J Trauma，2010，69(1)：104-109.
, http://www.100md.com
[3] He J，Gu D，Wu X，et al.Major causes of death among men and women in China[J].N Engl J Med，2005，353(11)：1124-1134.
[4] WHO.Global Burden of Disease 2002：Deaths by age，sex and cause for the year 2002[R].Geneva Switzerland：World Health Organization，2003.
[5] Schiff L，Hadker N，Weiser S，et al. A literature review of the feasibility of glial fibrillary acidic protein as a biomarker for stroke and traumatic brain injury[J].Mol Diagn Ther，2012，16：79-92.
, http://www.100md.com
[6] Ennen CS， Huisman TA，Savage WJ，et al.Glial fibrillary acidic protein as a biomarker for neonatal hypoxic-ischemic encephalopathy treated with whole- body cooling[J].Am J Obstet Gynecol，2011，205：251.
[7] Middeldorp J，Hol EM.GFAP in health and disease[J].Prog Neurobiol，2011，93： 421-443.
[8] 贾楠，张国军，康熙雄.GFAP对急性脑卒中早期鉴别诊断意义的初步探讨[J].中国免疫学杂志，2011，27(4)：368-370.
[9] Cheung WM，Wang CK，Kuo JS，et al.Changes in the level of glial fibrillary acidic protein(GFAP) after mild and severe focal cerebral ischemia[J].Chin J Physiol，1999，42：227-235.
, http://www.100md.com
[10] Nylén K，Csajbok LZ，Ost M，et al. Serum glial fibrillary acidic protein is related to focal brain injury and outcome after aneurysmal subarachnoid hemorrhage[J].Stroke，2007，38(5)：1489-1494.
[11] Song ZW， Wang D， Zhang N， et al. Association of vitamin B12， folic acid and homocysteine with depression[J].J Clin Res，2010，27(11)： 2001-2003.
[12] Foerch C，Niessner M，Back T，et al. Diagnostic accuracy of plasma glial fibrillary acidic protein for differentiating intracerebral hemorrhage and cerebral ischemia in patients with symptoms of acute stroke[J].Clin Chem，2012，58(1)：237-245.
(收稿日期：2014-08-24), 百拇医药(高元元 牛国平)
GFAP作为诊治脑卒中的重要实验室指标具有较高的敏感性和特异性，有助于鉴别缺血性脑卒中和出血性脑卒中[12]；脑梗塞后能早期释放且稳定，可迅速定量测定而且价廉，有助于临床医生诊断和评估脑卒中进展情况，改善病人的预后。
, 百拇医药
[参考文献]
[1] Zhu H，Dahlstr m A. Glial fibrillary acidic protein- expressing cellsin the neurogenic regions in normal and injured adult brains[J].J Neu-rosci Res，2007，85(12)：2783-2792.
[2] Honda M，Tsuruta R，Kaneko T，et al. Serum glial fibrillary acidic protein is a highly specific biomarker for traumatic brain injury in humans compared with S-100B and neuron- specific enolase[J].J Trauma，2010，69(1)：104-109.
, http://www.100md.com
[3] He J，Gu D，Wu X，et al.Major causes of death among men and women in China[J].N Engl J Med，2005，353(11)：1124-1134.
[4] WHO.Global Burden of Disease 2002：Deaths by age，sex and cause for the year 2002[R].Geneva Switzerland：World Health Organization，2003.
[5] Schiff L，Hadker N，Weiser S，et al. A literature review of the feasibility of glial fibrillary acidic protein as a biomarker for stroke and traumatic brain injury[J].Mol Diagn Ther，2012，16：79-92.
, http://www.100md.com
[6] Ennen CS， Huisman TA，Savage WJ，et al.Glial fibrillary acidic protein as a biomarker for neonatal hypoxic-ischemic encephalopathy treated with whole- body cooling[J].Am J Obstet Gynecol，2011，205：251.
[7] Middeldorp J，Hol EM.GFAP in health and disease[J].Prog Neurobiol，2011，93： 421-443.
[8] 贾楠，张国军，康熙雄.GFAP对急性脑卒中早期鉴别诊断意义的初步探讨[J].中国免疫学杂志，2011，27(4)：368-370.
[9] Cheung WM，Wang CK，Kuo JS，et al.Changes in the level of glial fibrillary acidic protein(GFAP) after mild and severe focal cerebral ischemia[J].Chin J Physiol，1999，42：227-235.
, http://www.100md.com
[10] Nylén K，Csajbok LZ，Ost M，et al. Serum glial fibrillary acidic protein is related to focal brain injury and outcome after aneurysmal subarachnoid hemorrhage[J].Stroke，2007，38(5)：1489-1494.
[11] Song ZW， Wang D， Zhang N， et al. Association of vitamin B12， folic acid and homocysteine with depression[J].J Clin Res，2010，27(11)： 2001-2003.
[12] Foerch C，Niessner M，Back T，et al. Diagnostic accuracy of plasma glial fibrillary acidic protein for differentiating intracerebral hemorrhage and cerebral ischemia in patients with symptoms of acute stroke[J].Clin Chem，2012，58(1)：237-245.
(收稿日期：2014-08-24), 百拇医药(高元元 牛国平)