陈亚男, 王雪丽, 刘忠伦, 吕晶晶, 吴晓, 何学明, 许瑾. 急性脑梗死病人外周血血管内皮生长因子动态变化与病情严重程度及预后相关性研究[J]. 蚌埠医学院学报, 2020, 45(11): 1481-1485. DOI: 10.13898/j.cnki.issn.1000-2200.2020.11.008
    引用本文: 陈亚男, 王雪丽, 刘忠伦, 吕晶晶, 吴晓, 何学明, 许瑾. 急性脑梗死病人外周血血管内皮生长因子动态变化与病情严重程度及预后相关性研究[J]. 蚌埠医学院学报, 2020, 45(11): 1481-1485. DOI: 10.13898/j.cnki.issn.1000-2200.2020.11.008
    CHEN Ya-nan, WANG Xue-li, LIU Zhong-lun, LÜ Jing-jing, WU Xiao, HE Xue-ming, XU Jin. Study on the relationship between the dynamic changes of vascular endothelial growth factor and severity, prognosis of patients with acute cerebral infarction[J]. Journal of Bengbu Medical College, 2020, 45(11): 1481-1485. DOI: 10.13898/j.cnki.issn.1000-2200.2020.11.008
    Citation: CHEN Ya-nan, WANG Xue-li, LIU Zhong-lun, LÜ Jing-jing, WU Xiao, HE Xue-ming, XU Jin. Study on the relationship between the dynamic changes of vascular endothelial growth factor and severity, prognosis of patients with acute cerebral infarction[J]. Journal of Bengbu Medical College, 2020, 45(11): 1481-1485. DOI: 10.13898/j.cnki.issn.1000-2200.2020.11.008

    急性脑梗死病人外周血血管内皮生长因子动态变化与病情严重程度及预后相关性研究

    Study on the relationship between the dynamic changes of vascular endothelial growth factor and severity, prognosis of patients with acute cerebral infarction

    • 摘要:
      目的探讨急性脑梗死(ACI)病人血清血管内皮生长因子(VEGF)水平变化的临床意义。
      方法收集2019年3-11月首次发生脑梗死并且24 h内入院的病人46例。使用了双抗体夹心酶联免疫吸附法(ELISA)连续测量入组病人的1、3、7、14 d清晨空腹状态下血清VEGF水平指标,同时根据美国国立卫生研究院卒中量表(NIHSS)的神经功能缺损程度评分结果将入院时病人分为轻、中、重度3组。并于发病14 d重新对病人进行评估,如果NIHSS评分较入院时下降≥4分或入院时评分 < 4分,重新评估后NIHSS评分未增加,则定义为预后好组,反之为预后差组。另外收集同阶段的年龄、性别匹配的15例经头颅CT或磁共振检查无异常的正常健康人作为对照组。
      结果与对照组比较,ACI组在发病1、3、7、14 d血清VEGF水平均明显升高(P < 0.01)。并且在ACI后7 d达到高峰。在ACI后14 d下降,但与对照组相比,差异仍有统计学意义(P < 0.01)。ACI组血清VEGF水平在不同时间点均随着病情严重程度增加而有上升趋势,并在发病7 d、14 d具有统计学意义(P < 0.05)。预后差组的ACI病人血清VEGF水平在各时点均表现出比预后好组高的趋势(P < 0.05)。进一步亚组分析,在相同卒中严重程度的情况下,预后差组的各时间点血清VEGF水平均有高于预后好组的趋势,但除轻度卒中组的1 d、3 d外(P < 0.05),2组差异无统计学意义(P>0.05)。ACI病人发病3、7、14 d血清VEGF水平与入院时NIHSS评分呈正相关关系(P < 0.05),NIHSS评分与发病1 d血清VEGF水平无明显相关性(P>0.05)。
      结论ACI发生后血清VEGF水平升高,且随ACI病程进展而呈波动性变化。血清VEGF水平与ACI病人的病情严重程度相关。血清VEGF水平与短期功能预后有一定的相关趋势。

       

      Abstract:
      ObjectiveTo investigate the clinical significance of the level change of serum vascular endothelial growth factor(VEGF) in patients with acute cerebral infarction(ACI).
      MethodsThe clinical data of 46 patients with the first cerebral infarction and hospitalized within 24 hours from March to November 2019 were collected.The double antibody sandwich enzyme-linked immunosorbent assay(ELISA) was used to continuously measure the fasting serum VEGF level after 1, 3, 7, and 14 days of admission.The patients at admission were divided into the mild, moderate and severe groups according to the neurological impairment score using the National Institutes of Health Stroke Scale(NIHSS).The patients were reevaluated after 14 days of onset.If the NIHSS score decreased by ≥4 points compared with that at admission or was less than 4 points at admission, and the NIHSS score did not increase after re-evaluation, the patients were defined as the group with good prognosis, and conversely as the group with poor prognosis.In addition, 15 normal healthy people with matched age and sex at the same stage measured by brain CT or MRI imaging were set as the control group.
      ResultsCompared with the control group, the serum VEGF level in ACI group significantly increased on day 1, 3, 7 and 14 of onset(P < 0.01), peaked after 7 days of ACI, and decreased after 14 days of ACI(P < 0.01).The serum VEGF level in ACI patients increased with the increasing of severity of disease at different time points.But except for 7th and 14th days after the onset, there was no statistical significance in the serum VEGF level among the mild, moderate and severe groups(P>0.05).The serum VEGF level of ACI patients in poor prognosis group showed a higher trend compared with the good prognosis group at all time points.And on the 3rd and 7th day after ACI, there were statistical differences between the two groups.The results of further subgroup analysis showed that under the same severity of stroke, the serum VEGF level in poor prognosis group had a higher trend compared with the good prognosis group at all time points.But except for 1 day 3 d day after the onset in mild stroke group(P < 0.01), the difference of the VEGF level between poor and good prognosis groups was not statistically significant(P>0.05).The serum VEGF levels in ACI patients on day 3, day 7 and day 14 of onset were positively correlated with the NIHSS score on admission(P < 0.05), and the correlation coefficients were 0.305, 0.346 and 0.355, respectively.There was no correlation between the NIHSS score and serum VEGF level on day 1 of the onset in ACI patients(P>0.05).
      ConclusionsThe serum VEGF level increases after the occurrence of ACI, and it fluctuates with the progression of ACI.The serum VEGF level is related to the severity of ACI.There is a correlation trend between serum VEGF level and short-term functional prognosis.

       

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