Abstract：
BACKGROUND: Diagnostic accuracy of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in identification of intracranial abnormalities detected by computed tomography (CT) in mild traumatic brain injury (mTBI), and in patients with mild neurological symptoms not caused by head trauma but suspected with a neurological disorder, was examined.
METHODS: GFAP and UCH-L1 were determined using the chemiluminescence immunoassays on the Alinity i analyzer (Abbott Laboratories).
RESULTS: Significantly higher GFAP (median 53.8 vs 25.7 ng/L, P < .001) and UCH-L1 (median 350.9 vs 153.9 ng/L, P < .001) were found in mTBI compared to non-head trauma patients. In mTBI diagnostic sensitivity (Se) and specificity (Sp) for the combination of GFAP and UCH-L1 were 100% and 30.9%, respectively, with area under the curve (AUC) 0.655. GFAP alone yielded Se 85.7%, Sp 41.8%, and AUC 0.638, while UCH-L1 yielded Se 57.1%, Sp 56.4%, and AUC 0.568. In non-head trauma patients, the combination of GFAP and UCH-L1 showed Se 100%, Sp 87.9%, and AUC 0.939, while GFAP alone demonstrated Se 100%, Sp 90.9%, and AUC 0.955.
CONCLUSIONS: If these results are reproduced on a larger sample, GFAP and UCH-L1 may reduce CT use in patients with mild neurological symptoms after systemic causes exclusion and neurologist\'s evaluation.
METHODS: GFAP and UCH-L1 were determined using the chemiluminescence immunoassays on the Alinity i analyzer (Abbott Laboratories).
RESULTS: Significantly higher GFAP (median 53.8 vs 25.7 ng/L, P < .001) and UCH-L1 (median 350.9 vs 153.9 ng/L, P < .001) were found in mTBI compared to non-head trauma patients. In mTBI diagnostic sensitivity (Se) and specificity (Sp) for the combination of GFAP and UCH-L1 were 100% and 30.9%, respectively, with area under the curve (AUC) 0.655. GFAP alone yielded Se 85.7%, Sp 41.8%, and AUC 0.638, while UCH-L1 yielded Se 57.1%, Sp 56.4%, and AUC 0.568. In non-head trauma patients, the combination of GFAP and UCH-L1 showed Se 100%, Sp 87.9%, and AUC 0.939, while GFAP alone demonstrated Se 100%, Sp 90.9%, and AUC 0.955.
CONCLUSIONS: If these results are reproduced on a larger sample, GFAP and UCH-L1 may reduce CT use in patients with mild neurological symptoms after systemic causes exclusion and neurologist\'s evaluation.
摘要：
背景：神经胶质纤维酸性蛋白（GFAP）和泛素C末端水解酶L1（UCH-L1）在识别轻度创伤性脑损伤（mTBI）中通过计算机断层扫描（CT）检测到的颅内异常中的诊断准确性，对于不是由头部外伤引起的但怀疑患有神经系统疾病的轻度神经系统症状的患者，被检查过。
方法：GFAP和UCH-L1使用Alinityi分析仪（AbbottLaboratories）上的化学发光免疫测定法测定。
结果：GFAP明显更高（中位数53.8比25.7ng/L，P<.001）和UCH-L1（中位数350.9比153.9ng/L，与非头部创伤患者相比，在mTBI中发现P<.001）。在mTBI中，GFAP和UCH-L1组合的诊断敏感性（Se）和特异性（Sp）分别为100％和30.9％，分别,曲线下面积（AUC）0.655。仅GFAP就产生了85.7%的硒，每股41.8%，AUC0.638，而UCH-L1的产量为57.1%，Sp56.4%，和AUC0.568。在非头部外伤患者中，GFAP和UCH-L1的组合显示硒100%，Sp87.9%，和AUC0.939，而单独的GFAP显示硒100%，Sp90.9%，和AUC0.955。
结论：如果这些结果在较大的样本上重现，在全身性原因排除和神经科医生评估后，GFAP和UCH-L1可能会减少轻度神经系统症状患者的CT使用。
方法：GFAP和UCH-L1使用Alinityi分析仪（AbbottLaboratories）上的化学发光免疫测定法测定。
结果：GFAP明显更高（中位数53.8比25.7ng/L，P<.001）和UCH-L1（中位数350.9比153.9ng/L，与非头部创伤患者相比，在mTBI中发现P<.001）。在mTBI中，GFAP和UCH-L1组合的诊断敏感性（Se）和特异性（Sp）分别为100％和30.9％，分别,曲线下面积（AUC）0.655。仅GFAP就产生了85.7%的硒，每股41.8%，AUC0.638，而UCH-L1的产量为57.1%，Sp56.4%，和AUC0.568。在非头部外伤患者中，GFAP和UCH-L1的组合显示硒100%，Sp87.9%，和AUC0.939，而单独的GFAP显示硒100%，Sp90.9%，和AUC0.955。
结论：如果这些结果在较大的样本上重现，在全身性原因排除和神经科医生评估后，GFAP和UCH-L1可能会减少轻度神经系统症状患者的CT使用。
