Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan.
Neurocrit Care. 2010 Apr;12(2):252-7. doi: 10.1007/s12028-009-9318-5.
In past research, procalcitonin (PCT) and glial fibrillary acidic protein (GFAP) have been reported to be useful biomarkers in predicting neurological outcome after the return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (CA), although they have only been studied separately. In this study, we compared the usefulness of PCT and GFAP in predicting neurological outcome.
This study was a retrospective, single-center analysis, conducted in the intensive-care unit of a university hospital. Twenty-one sequential post-CA patients were included. Serum samples were collected from patients at 12 and 24 h after ROSC. Serum PCT and GFAP were measured and compared in patients with favorable and unfavorable neurological outcomes, evaluated at 6 months using the Glasgow-Pittsburgh Cerebral Performance Categories.
Serum PCT was significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.004 and 0.002, respectively). Serum GFAP was not significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.118 and 0.079, respectively). The combination of PCT and GFAP showed high predictive value for unfavorable outcomes (86.7% sensitivity and 100% specificity at 12 h; 100% sensitivity and 83.3% specificity at 24 h).
Serum PCT is a marker of unfavorable neurological outcome in post-CA patients, and is superior to serum GFAP in the early phase.
既往研究表明，降钙素原（PCT）和胶质纤维酸性蛋白（GFAP）在预测院外心脏骤停（CA）后自主循环恢复（ROSC）后的神经功能结局方面是有用的生物标志物，尽管它们仅分别进行了研究。在本研究中，我们比较了 PCT 和 GFAP 在预测神经功能结局方面的作用。
本研究是一项回顾性、单中心分析，在一所大学医院的重症监护病房进行。纳入了 21 例连续的 CA 后患者。在 ROSC 后 12 和 24 小时采集血清样本。测量血清 PCT 和 GFAP，并比较神经功能结局良好和不良患者的差异，6 个月时采用格拉斯哥-匹兹堡脑功能表现分类进行评估。
神经功能结局不良患者在 12 和 24 小时时的 PCT 血清水平显著升高（P = 0.004 和 0.002）。神经功能结局不良患者在 12 和 24 小时时的 GFAP 血清水平无显著升高（P = 0.118 和 0.079）。PCT 和 GFAP 的联合检测对不良结局具有较高的预测价值（12 小时时的敏感性为 86.7%，特异性为 100%；24 小时时的敏感性为 100%，特异性为 83.3%）。
血清 PCT 是 CA 后患者不良神经结局的标志物，在早期优于 GFAP。
