国际麻醉学与复苏杂志   2013, Issue (2): 1-1
    
生物标志物在创伤性颅脑损伤中的应用
于芸, 韩如泉1()
1.首都医科大学附属北京天坛医院麻醉科
Application of biomarkers in traumatic brain injury
 全文:
摘要:

背景 创伤性颅脑损伤(traumatic brain injury, TBI)是青壮年致死致残的主要原因之一,生物标志物可定量评估脑损伤程度、预测疾病转归。 目的 探讨各种标志物用于评估脑损伤程度及转归的机制、研究现状及临床应用前景。 内容 综述脑外伤后神经元损伤标志物[神经元特异性烯醇化酶(neuron specific enolase, NSE)]、泛素C末端水解酶L1(ubiquitin c-terminal hydrolase-L1, UCH-L1)、 Tau蛋白、胶质细胞损伤标志物(胶质细胞纤维酸性蛋白、S100)、炎性标志物[白细胞介素(interleukin, IL)-1、IL-6、IL-10、IL-8、肿瘤坏死因子-α(tumor necrosis factor, TNF-α)]以及其他标志物(髓鞘碱性蛋白、膜收缩蛋白及其降解产物)的时程特点、评估损伤程度及预测转归的敏感性和特异性。 趋向 生物标志物辅助诊断TBI、预测神经系统转归、监测继发性损伤的临床应用价值有待进一步研究。

关键词: 创伤性颅脑损伤;生物标志物;神经元特异性烯醇化酶;泛素C末端水解酶L1;tau蛋白;胶质细胞纤维酸性蛋白;S100
Abstract:

Background Traumatic brain injury(TBI) is the leading cause of death and disability among young adults. Biomarkers can be used to evaluate the severity of brain injury quantitatively and predict neurological outcome. Objective To discuss the mechanisms, current research status and clinical application prospects of biomarkers in assessing the degree of injury and predicting outcomes of TBI. Content In this review, the available data from biomarkers of TBI including neuron specific biomarkers (neuron specific enolase, ubiquitin C-terminal hydrolase-L1 and Tau protein), glial cell specific biomarkers (glial fibrillary acidic protein and S100), inflammatory biomarkers (IL-1, IL-6, IL-10, IL-8, TNF-α) and others (mylin basic protein, spectrin and its breakdown products) was overviewed. Time course, sensitivity and specificity of the above biomarkers were discussed. Trend The candidate biomarkers can be applied to aid the diagnosis of TBI, predict neurological outcomes and monitor secondary injury. However, the clinical utility needs to be further explored.

Key words: Traumatic brain injury; Biomarker; Neuron specific enolase; Ubiquitin C-terminal hydrolase-L1; tau protein; Glial fibrillary acidic protein; S100