P-选择素、血管内皮生长因子在皮质下动脉硬化性脑病中的表达及意义

Expression and significance of P-selectin and vascular endothelial growth factor in subcortical arteriosclerotic encephalopathy

目的探讨皮质下动脉硬化性脑病(SAE)患者血P-选择素、血管内皮生长因子(VEGF)水平及其与血糖、血脂和C反应蛋白(CRP)的相关性。方法测定54例SAE患者(SAE组)、57名健康老年人(健康对照组)血浆P-选择素、血清VEGF、血糖、血脂、CRP水平,并进行比较和相关分析。结果SAE组P-选择素[(17.61±5.63)ng/ml]、VEGF[(126.33±47.51)pg/ml]水平明显高于健康对照组[(14.72±3.89)ng/ml,(102.59±40.16)pg/ml](均P<0.01);P-选择素水平随痴呆程度加重而升高,痴呆中、重度组VEGF水平[(152.46±53.75)pg/ml、(150.52±55.94)pg/ml]明显高于轻度组[(126.79±44.83)pg/ml](P<0.01,P<0.05);中、重度组间差异无统计学意义。SAE组P-选择素与血糖、三酰甘油(TG)、CRP呈正相关(r=0.282、0.293、0.287,均P<0.05);VEGF与总胆固醇(TC)、CRP呈正相关(r=0.291、0.336,均P<0.05);P-选择素与VEGF呈正相关(r=0.295,P<0.05)。结论P-选择素、VEGF参与了SAE的血栓形成和组织修复过程;检测P-选择素、VEGF水平,指导抗血小板药物的应用,对预防SAE可能有重要意义。

Objective To explore the levels of plasma P-selectin and serum vascular endothelial growth factor （VEGF） and the correlations with blood lipid and c-reative protein （CRP） in patients with subcortical arteriosclerotic encephalopathy （SAE）. Methods The levels of plasam P-selectin, serum VEGF, blood glucose, blood lipid and CRP from the SAE group with 54 patients, and normal control （NC） group with 57 healthy elder were compared and correlated analyzed. Results The levels of P-selectin [ （ 17.61 ± 5.63 ）ng/ml ] and VEGF[ （ 126.33± 47.51 ）pg/ ml] in SAE group were significantly higher than those in NC group[ （ 14.72± 3.89 ）ng/ml, （ 102.59 ± 40.16 ）pg/ ml] （all P 〈0. 01 ）. The level of P-selectin was higher as degree of dementia worsened. The levels of VEGF were significantly higher in moderate and severe dementia groups [ （ 152.46± 53.75 ） pg/ml, （ 150.52 ± 55.94 ） pg/ml] than that in low-grade dementia group[ （ 126.79±44.83 ）pg/ml] （P 〈0. 01, P 〈0. 05）. There was no significance difference between groups moderate and severe . The level of P-selectin in the SAE group was positively correlated with blood glucose, triglyceride （TG） and CRP （ r = 0. 282,0.293,0. 287, all P 〈 0. 05 ）. The level of VEGF was positively correlated with total cholesterol（TC） and CRP （r = 0. 291,0. 336, all P 〈 0. 05 ）. The level of P-selectin was positively correlated with VEGF （ r = 0. 295, P 〈 0. 05 ）. Conclusions The P-selectin and VEGF may be involved in the process of formation of thrombus and restoration of tissues of SAE. Indicates the levels of P-selectin and VEGF will be helpful for the application of antiplatelet medications in prevention of SAE.