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.
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。