Abstract

Objective: To explore the dynamic changes of the neuro-specific molecular markers S100 calcium-binding protein β (S100β), neuron-specific enolase (NSE) and glial fibrillary acid protein (GFAP) in the blood of patients with acute cerebrovascular accident (ACVA) in the emergency department, as well as their relationship with the clinical outcomes of patients, so as to provide a reference for the clinical diagnosis and treatment of ACVA.
Methods: A total of 150 patients with ACVA who visited the emergency department of the First Affiliated Hospital of Chengdu Medical College from January 2022 to December 2023 were prospectively enrolled, and 50 healthy volunteers were selected as controls. Peripheral venous blood was collected at 2h, 6h, 12h, 24h, 48h, 72h and 7d after the onset of the disease, and the concentrations of S100β, NSE and GFAP in serum were detected by enzyme-linked immunosorbent assay (ELISA). Three months after onset, the modified Rankin scale (mRS) was used to evaluate the clinical outcomes of patients. One-way analysis of variance and Pearson correlation analysis were used to analyze the dynamic changes of markers and their correlation with clinical outcomes.
Results: Serum S100β in the patient group increased significantly at 2h after onset and reached a peak at 6h; NSE began to increase at 6h after onset and reached a peak at 12-24h; GFAP increased at 12h after onset and reached a peak at 24-48h, and the change trends of different markers were different between ischemic and hemorrhagic stroke patients. The serum S100β, NSE, and GFAP concentrations of patients in the poor prognosis group were significantly higher than those in the good prognosis group at each time point (P < 0.01), and the concentrations of the three were significantly positively correlated with the mRS scores (r values were 0.65, 0.58, and 0.62, respectively, all P < 0.01).
Conclusion: The dynamic changes of S100β, NSE and GFAP are closely related to the condition and prognosis of ACVA patients, and are expected to become important biomarkers for early diagnosis, disease monitoring and prognosis evaluation of ACVA, but further verification is still needed in multicenter large-sample studies.

Keywords

Acute cerebrovascular accident, neurospecific molecular markers, dynamic changes, clinical outcomes