摘要
目的探讨血清血管内皮生长因子(VEGF)和S100β蛋白与急性脑梗死患者近期预后的相关性。方法选取132例急性脑梗死患者为研究组,检测患者入院时和入院3d、7 d、14 d血清VEGF及S100β蛋白水平,同期选取100例与患者年龄、性别相匹配的健康体检者为对照组;按照3个月后的改良Rankin量表(mRS)对研究组患者预后进行评估,将患者分为预后良好组69例及预后不良组63例,比较2组相关指标的差异,利用Logistic回归方程分析血清VEGF及S100β蛋白水平与患者预后的关系,并应用ROC曲线评估二者预测患者预后不良的临床价值。结果预后不良组及预后良好组血清VEGF水平均在入院7 d时达到峰值,之后开始降低,2组入院时及入院3 d、7 d、14 d血清VEGF水平均高于对照组(P均<0.05),且预后不良组入院3 d、7 d、14 d血清VEGF水平均高于预后良好组(P均<0.05);预后不良组及预后良好组血清S100β蛋白水平均在入院3 d时达到峰值,2组入院时和入院3 d、7 d血清S100β蛋白水平均高于对照组(P均<0.05),预后不良组入院3 d、7 d、14 d血清S100β蛋白水平均高于预后良好组(P均<0.05)。多因素Logistic回归分析显示:血清VEGF水平[OR=1.889,95%CI(1.228,2.789)]及S100β蛋白水平[OR=1.569,95%CI(1.241,2.648)]是急性脑梗死患者近期预后不良的独立危险因素。ROC曲线分析显示:血清VEGF及S100β蛋白水平预测患者预后不良的曲线下面积分别为0.882,0.823;灵敏度分别为90.1%,87.9%;特异度分别为79.6%,78.1%。结论血清VEGF及S100β蛋白水平在急性脑梗死患者早期显著升高,可能是患者近期预后不良的独立危险因素,应当引起临床重视。
Objective It is to investigate the correlation of serum vascular endothelial growth factor（ VEGF） and S100βproteins with recent prognosis of patients with acute cerebral infarction. Methods 132 cases of acute cerebral infarction patients were chosen as the research object. Serum VEGF and S100β were determined at admission,in 3 d,7 d after admission,100 patients with the same period of age and gender matched healthy check-up for reference were selected as control group.According to three months after the modified Rankin scale（ mRS） the prognosis of patients were evaluated,the they were divided into good prognosis group（ n = 69） and poor prognosis group（ n = 63）,the difference in related indicators between the two groups were compared. Logistic regression equation analysis was used to analyze correlation of serum VEGF and S100βwith recent prognosis,and ROC curve was used to evaluate the value for predict poor prognosis. Results The serum levels of VEGF in patients with good prognosis group and poor prognosis group reach peak value in 7 days after admission,then began to reduce. The level of serum VEGF was higher in patient groups than that in control group at admission,in 3 d,7 d after admission（ P〈0. 05）,the level in good prognosis group was lower than that in poor group in 3 d,7 d,14 d after hospital admission（ P〈0. 05）. The serum levels of S100β in patients with good prognosis group and poor prognosis group reach peak value in 3 days after admission,the level of serum S100β was higher in patient groups than that in control group at admission,in 3d,7 d after admission（ P〈0. 05）,the level in good prognosis group was lower than that in poor group in 3 d,7 d,14 d after hospital admission（ P〈0. 05）. Multiariable Logistic regression analysis showed that average serum VEGF [OR = 1. 889,95%CI（ 1. 228,2. 789） ],and S100β[OR = 1. 569,95% CI（ 1. 241,2. 648） ] were independent risk factors of poor prognosis in patients with acute cerebral infarction. ROC curve analysis showed that： serum levels of VEGF and S100β area under thecurve of average predict prognosis in patients with（ ROCAUC） were： 0. 882,0. 823 respectively; sensitivity were respectively： 90. 1%,87. 9%; specific degrees were respectively： 79. 6%,79. 6%. Conclusion Serum VEGF and S100β significantly increase in patients with early acute cerebral infarction,which may be recent independent risk factors of poor prognosis and should be pay more attention in clinic.
出处
《现代中西医结合杂志》
CAS
2016年第32期3544-3547,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
河北省科学技术研究与发展支撑计划项目(12277710)
