急性脑梗死患者血清血管内皮生长因子浓度变化的临床意义

Clinical significance of changes of serum VEGF concentration in patients with acute cerebral infarction

目的探讨急性脑梗死患者血清血管内皮生长因子(VEGF)浓度变化的临床意义。方法采用ELISA法动态检测40例急性脑梗死患者(梗死组)即刻、第3、7、14天和20例健康体检者(对照组)空腹血清VEGF浓度,观察VEGF与脑梗死病程、梗死灶大小、部位的关系。结果梗死组患者血清VEGF浓度显著高于对照组,且在急性期VEGF浓度持续升高,至病程第7天达高峰,以后开始下降,但至14天仍维持高水平。皮质脑梗死VEGF浓度较皮质下脑梗死显著增高(P<0.01)。脑梗死灶体积大的VEGF浓度越高;随病情加重VEGF浓度也随之升高,尤以第7天明显(P<0.01),梗死组外周血单核细胞数也较对照组明显升高(P<0.01)。结论急性脑梗死患者血清VEGF浓度的变化与病程、脑梗死灶大小、部位及病情严重程度具有相关性,提示VEGF的浓度与脑梗死后新血管形成有密切关系。

Objective To investigate the clinical significance of changes of serum vascular endothelial growth factor（VEGF） concentration in patients with acute cerebral infarction （ACI）. Methods VEGF concentration of 40 patients with ACI was serially examined by ELISA and relationship between VEGF concentration and disease course,size,focus of ACI was observed. Results VEGF concentration in ACI was higher than that in healthy controls （P〈0.01）. It increased progressively and reached the peak on day 7 after ACI. VEGF concentration in cortex infarction was higher than that in subcortex infarction. The bigger the volume of infarction, the higher the VEGF concentration, and the change of VEGF concentration was parallel to the severity of ACI, specially on day 7 after stroke. Count of monocytes/macrophages in peripheral blood of ACI patients was higher than that in controls. Conclusion Serum VEGF originates from peripheral monocytes/ macrophages, neurons and glia in the core and penumbra of infarction. The change of VEGF related to disease course, and volume, location and severity of ACI. It is suggested that VEGF, which is important in angiogenesis,may also influence long-term neuronal survival,and possibly its modulation may be of therapeutic value for patients with ischemic stroke.