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

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.