创伤性蛛网膜下腔出血后血管内皮生长因子与脑血管痉挛的相关性研究

Correlation of cerebral vasospasm with vascular endothelial growth factor after traumaticsubarchnoid hemorrhage

目的研究创伤性蛛网膜下腔出血（traumaticsubarachnoidhemorrhage，tSAH）患者血清血管内皮生长因子（vascularendothelialgrowthfactor，VEGF）水平变化与脑血管痉挛（cerebralvasospasm，cvs）及其严重程度的动态相关性。方法收集48例tSAH患者，进行cT影像评估，采用经颅多普勒（TCD）动态检测患者伤后1，3，5，7，10，15d大脑中动脉流速，并进行临床分级。采集患者静脉血，通过ELISA法测定患者伤后1，3，5，7，10，15d静脉血清中VEGF水平；分析患者血清VEGF水平变化与CVS严重程度的动态相关性。同时纳入10名健康志愿者作为对照组。结果发生CVS的患者血清中VEGF水平明显高于未发生CVS的患者，也明显高于对照组的健康志愿者。其中，重度CVS患者血清VEGF表达水平持续增高。结论血清VEGF水平的动态变化可反映tSAH后CVS的严重程度，可为早期诊断CVS提供依据。

Objective To investigate dynamic relation of serum levels of vascular endothelial growth factor （VEGF） with occurrence and severity of cerebral vasospasm （CVS） in patients with traumatic subarachnoid hemorrhage （tSAH）. Methods Forty-eight patients with tSAH were involved in the study. All the patients received CT imaging assessment. All patients received TCD dynamic monitoring of flow velocity of middle cerebral artery at days 1, 3, 5, 7, 10 and 15 after admission for clinical classification of CVS. The venous blood samples were obtained to determine VEGF levels in the serum by ELISA at days 1, 3, 5, 7, 10 and 15 after admission and dynamic relationship between CVS severity and serum VEGF was evaluated. Ten normal volunteers were included as the control group. Results Serum levels of VEGF in patients with secondary CVS were significantly higher than those without CVS and normal volunteers in the control group. Additionally, expression levels of VEGF in the serum kept persistent increase in patients with severe CVS. Conclusion Dynamic variation of serum VEGF levels in patients with tSAH may be an indicator of CVS severity and hence may provide a basis for early diagnosis of CVS.