急性脑梗死患者治疗前后VEGF水平动态变化的研究

Study on the Dynamic Changes in VEGF Before and After Treatment in the Patients with Acute Cerebral Infarction

目的探讨急性脑梗死患者血清血管内皮细胞生长因子(VEGF)含量在不同时间段的变化及脑心通胶囊治疗对其的影响。方法选择60例脑梗死患者随机分为治疗组和对照组各30例,并设立健康组60例,治疗组给予脑心通胶囊口服。采用双抗体夹心ELISA法于24h内、3d、7d、14d检测患者血清VEGF含量,同时测定患者血浆纤维蛋白原(FIB)水平,治疗前及治疗后14d进行神经功能评分。结果急性脑梗死患者各时间点血清VEGF及FIB的水平明显高于正常组(P<0.01),且在急性期VEGF及FIB的浓度持续升高,至病程第7天均达高峰,以后开始下降,但至第14天仍维持高水平;应用脑心通胶囊干预治疗后血清VEGF一直保持在一个相对较高的水平,于第3、7、14天明显高于对照组,第7天最为显著(P<0.01),而动态观察两组的FIB水平差异无统计学意义(P>0.05);应用脑心通胶囊干预治疗14d后,治疗组神经功能评分优于对照组,两组差异有统计学意义(P<0.05)。结论急性脑梗死后血清VEGF浓度明显增高,脑心通胶囊能促进VEGF的产生和分泌,且能提高临床疗效。

Objective To investigate the changes in the concentration of serum vascular endothelial growth factor（VEGF）at different time stages,as well as the impacts of naoxintong capsule in the patients with acute cerebral infarction.Methods 60 cases of cerebral infarction were randomly divided into treatment group and control group,30 cases in each one.Additionally,60 cases were included in healthy group.Naoxintong capsule was administered in treatment group orally.The double-antibody sandwich ELISA was used to detect serum VEGF concentration in 24 h,3 d,7 d and 14 d separately.Meanwhile,plasma fibrinogen（FIB）level and neurological function score before treatment and 14 d after treatment were determined.Results The levels of VEGF and FIB in the patients with acute cerebral infarction were significantly higher than those in the normal group at all time points（P0.01）,The concentration of VEGF and FIB increased continuously at each time point and were up to the peak on the 7th day of the sickness.Afterward,they started decreasing,but still maintained at a high level on the 14th day.Serum VEGF concentration had been maintained at a relatively high level after the intervention with naoxintong capsule and its concentration was higher apparently than that in control group on the 3rd,4th and 14th days,which was higher significantly on the 7th day（P0.01）.The dynamic observation did not discover significant difference in FIB level between two groups（P0.05）.14 days after the intervention with naoxintong capsule,the neurologic function score in treatment group was superior to that in control group,indicating statistical significance.Conclusion The serum VEGF concentration increases apparently after acute cerebral infarction.Naoxintong capsule can promote the production and secretion of VEGF and improve clinical efficacy.