急性脑梗死患者血清PD—ECGF和VEGF的动态变化

Dynamic changes of platelet derived endothelial cell growth factor and vascular endothelial growth factor in the serum of patients with acute cerebral infarction

目的探讨急性脑梗死患者血清血小板衍生内皮细胞生长因子（PD—ECGF）和血管内皮细胞生长因子（VEGF）的动态变化并分析与梗死灶大小、梗死病因类型的相关性。方法采用双抗体夹心酶联免疫吸附法（ELISA）动态测定34例急性脑梗死患者在发病后第1、3、7、14天时血清PD—ECGF和VEGF的浓度，对照组为30例本院健康体检者。并根据体积大小分为3组：大梗死灶组10例，中等梗死灶组13例和小梗死灶组11例。根据病因学分为大动脉粥样硬化组15例，小血管病变组10例和心源性组9例。分析血清PD—ECGF和VEGF浓度变化与梗死灶大小、梗死病因类型相关性。结果急性脑梗死患者在中风后各时间点的血清PD—ECGF和VEGF浓度均明显增高（均P〈0．05），其中血清PD—ECGF浓度在中风后3d达高峰，血清VEGF浓度在中风后7d达高峰，两组浓度在中风后14d一直维持增高。血清PD—ECGF和VEGF浓度在大梗死灶组和大动脉粥样硬化组中增高明显，差异均有统计学意义（均P〈0．05）。结论急rIIE,~6梗死患者血清PD—ECGF和VEGF浓度有明显的增高，升高程度和梗死杜大小、病因类型相关．血清PD—ECGF浓度达峰时间早于血清VEGF浓度达峰时间。PD—ECGF和VEGF在急性脑梗死的病理生理机制中起着重要作用，有望在以后的治疗中发挥作用。

Objective TO investigate the dynamic changes of platelet derived endothelial cell growth factor （PD-ECGF） and vascular endothelial growth factor （VEGF） in the serum of patients with acute cerebral infarction （ACI）. Methods Thirty four patients with acute cerebral infarction and 30 healthy subjects （control group）were enrolled in the study. The PD-ECGF and VEGF levels were detected by ELISA in patients on dl, d3, d7 and d14 after infarction as well as in healthy controls. According to the size of lesions the patients were classified as large lesion group （n=10）, middle lesion group （lz=13） and small lesion group （n=l 1）; according to the etiology patients were classified as large-artery atherosclerosis group （LAA, n=15）, small-artery occlu- sion （SAO, n=10） group and cardioembolism （CE, n=9） group. Then the correlation between serum PD-ECGF,VEGF levels and infarct size, etiology were analyzed. Results Serum PD-ECGF and VEGF levels were significantly increased in patients with ACI at all time points compared with healthy controls （P〈0.05）. The levels of PD-ECGF in serum reached peak value after 3d, and VEGF reached peak value after 7d, and they remained high levels at d14 after stroke. PD-ECGF and VEGF showed dramatic in- crease in serum of large lesion group and LAA group （P〈0.05）. Conclusion The contents of serum PD-ECGF and VEGF in- crease dramatically in patients with acute cerebral infarction, and have correlation with infarct volume and etiology. The results in- dicate that PD-ECGF and VEGF may be involved in the pathophysiology of acute cerebral infarction.