Zanier E R, Longhi L, Fiorini M, Cracco L, Bersano A, Zoerle T, Branca V, Monaco S, Stocchetti N
Neurosurgical Intensive Care Unit, Department of Anesthesia and Critical Care Medicine, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, University of Milano, Milano, Italy.
Acta Neurochir Suppl. 2008;102:339-43. doi: 10.1007/978-3-211-85578-2_65.
Heart-type Fatty Acid-Binding Protein (H-FABP) and tau protein (tau) have been shown to be novel biomarkers associated with brain injury and, therefore, they could represent a useful diagnostic tool in patients with subarachnoid hemorrhage (SAH). The goal of this study was to measure H-FABP and tau in cerebrospinal fluid (CSF) following SAH to test the hypothesis that a relationship exists between SAH severity and H-FABP/tau values.
Twenty-seven consecutive SAH patients admitted to our ICU were studied. Serial CSF samples were obtained in every patient starting on the day of SAH and daily for up to 2 weeks post-SAH. H-FABP/tau levels were measured by enzyme-linked immunosorbent assay.
Patients with severe SAH showed significantly higher peak levels of H-FABP and tau compared to mild-SAH patients (FABP: p = 0.02; tay: p = 0.002). In addition the peak concentrations of H-FABP and tau in CSF from SAH patients correlated significantly with Glasgow Coma Scale motor score (H-FABP: Spearman r = -0.52, p = 0.006; tau: Spearman r = -0.63, p = 0.0004). Based on outcome at discharge from the hospital, patients were categorized into survivors and non-survivors. Peak concentrations of both proteins in the non-survivors group were significantly higher than in the survivors.
H-FABP and tau CSF levels are proportional to SAH severity and may be novel biomarkers that can be used to predict the severity of outcome following clinical SAH.
心型脂肪酸结合蛋白（H-FABP）和tau蛋白已被证明是与脑损伤相关的新型生物标志物，因此，它们可能是蛛网膜下腔出血（SAH）患者有用的诊断工具。本研究的目的是测量SAH后脑脊液（CSF）中的H-FABP和tau，以检验SAH严重程度与H-FABP/tau值之间存在关系的假设。
对入住我们重症监护病房的27例连续SAH患者进行研究。从SAH当天开始，每位患者每天采集系列脑脊液样本，持续至SAH后2周。通过酶联免疫吸附测定法测量H-FABP/tau水平。
与轻度SAH患者相比，重度SAH患者的H-FABP和tau峰值水平显著更高（FABP：p = 0.02；tau：p = 0.002）。此外，SAH患者脑脊液中H-FABP和tau的峰值浓度与格拉斯哥昏迷量表运动评分显著相关（H-FABP：Spearman r = -0.52，p = 0.006；tau：Spearman r = -0.63，p = 0.0004）。根据出院时的结果，将患者分为幸存者和非幸存者。非幸存者组中两种蛋白质的峰值浓度均显著高于幸存者。
H-FABP和tau脑脊液水平与SAH严重程度成正比，可能是可用于预测临床SAH后预后严重程度的新型生物标志物。
