Abstract：
OBJECTIVE: This study aimed to explore the potential of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) as biomarkers for diagnosis and prognosis in mild and severe TBI cases, including TBI-related deaths.
METHODS: This prospective cohort study includes 40 cases each of mild, severe, fatal TBI cases, and 40 healthy controls. Serum samples were collected from live patients at 8 and 20 h post injury for UCH-L1 and GFAP respectively, and from deceased patients within 6 h of death.
RESULTS: Elevated levels of both GFAP and UCH-L1 were observed in patients with severe and fatal TBI cases. These biomarkers exhibited promising potential for predicting various Glasgow Outcome Scale Extended (GOSE) categories. Combining GFAP and UCH-L1 yielded higher predictive accuracy both for diagnosis and prognosis in TBI cases. The study additionally established specific cut-off levels for GFAP and UCH-L1 stratified according to the severity and prognosis.
CONCLUSIONS: GFAP and UCH-L1 individually demonstrated moderate to good discrimination capacity in predicting TBI severity and functional outcomes. However, combining these biomarkers is recommended for improved diagnostic and prognostic utility. This precision tool can enhance patient care, enabling tailored treatment plans, ultimately reducing morbidity and mortality rates in TBI cases.
METHODS: This prospective cohort study includes 40 cases each of mild, severe, fatal TBI cases, and 40 healthy controls. Serum samples were collected from live patients at 8 and 20 h post injury for UCH-L1 and GFAP respectively, and from deceased patients within 6 h of death.
RESULTS: Elevated levels of both GFAP and UCH-L1 were observed in patients with severe and fatal TBI cases. These biomarkers exhibited promising potential for predicting various Glasgow Outcome Scale Extended (GOSE) categories. Combining GFAP and UCH-L1 yielded higher predictive accuracy both for diagnosis and prognosis in TBI cases. The study additionally established specific cut-off levels for GFAP and UCH-L1 stratified according to the severity and prognosis.
CONCLUSIONS: GFAP and UCH-L1 individually demonstrated moderate to good discrimination capacity in predicting TBI severity and functional outcomes. However, combining these biomarkers is recommended for improved diagnostic and prognostic utility. This precision tool can enhance patient care, enabling tailored treatment plans, ultimately reducing morbidity and mortality rates in TBI cases.
摘要：
目的：本研究旨在探讨胶质纤维酸性蛋白（GFAP）和泛素C末端水解酶-L1（UCH-L1）作为轻度和重度TBI患者诊断和预后的生物标志物的潜力。包括与TBI相关的死亡。
方法：这项前瞻性队列研究包括40例轻度，严重,致命的TBI病例,和40个健康对照。分别在伤后8小时和20小时从活体患者中收集血清样本，用于检测UCH-L1和GFAP。以及死亡后6小时内的死者。
结果：在严重和致命TBI患者中观察到GFAP和UCH-L1水平升高。这些生物标志物显示出预测各种格拉斯哥结果扩展量表（GOSE）类别的有希望的潜力。结合GFAP和UCH-L1对TBI病例的诊断和预后均具有更高的预测准确性。该研究还建立了根据严重程度和预后分层的GFAP和UCH-L1的特定截止水平。
结论：GFAP和UCH-L1在预测TBI严重程度和功能结局方面分别表现出中等至良好的辨别能力。然而,建议将这些生物标志物结合使用,以提高诊断和预后的效用.这种精密的工具可以提高病人的护理，实现量身定制的治疗计划，最终降低TBI病例的发病率和死亡率。
方法：这项前瞻性队列研究包括40例轻度，严重,致命的TBI病例,和40个健康对照。分别在伤后8小时和20小时从活体患者中收集血清样本，用于检测UCH-L1和GFAP。以及死亡后6小时内的死者。
结果：在严重和致命TBI患者中观察到GFAP和UCH-L1水平升高。这些生物标志物显示出预测各种格拉斯哥结果扩展量表（GOSE）类别的有希望的潜力。结合GFAP和UCH-L1对TBI病例的诊断和预后均具有更高的预测准确性。该研究还建立了根据严重程度和预后分层的GFAP和UCH-L1的特定截止水平。
结论：GFAP和UCH-L1在预测TBI严重程度和功能结局方面分别表现出中等至良好的辨别能力。然而,建议将这些生物标志物结合使用,以提高诊断和预后的效用.这种精密的工具可以提高病人的护理，实现量身定制的治疗计划，最终降低TBI病例的发病率和死亡率。
