颅脑损伤患者血管内皮生长因子水平及其与预后的关系

Levels of vascular endothelial growth factor(VEGF) in patients with traumatic brain injury and its correlation with prognosis

目的动态监测颅脑损伤患者血清血管内皮生长因子水平,探讨其与疾病严重程度及预后的关系。方法选取颅脑损伤患者53例,按GCS(Glasgow Coma Scale)分为轻(11例)、中(19例)、重(23例)型3组。选取体检健康者20名作为对照组。对照组静脉血体检时获得,颅脑外伤患者均于发病后1、3、7 d抽取静脉血。采用酶联免疫吸附法检测血清VEGF水平。结果轻、中、重型颅脑损伤患者血清VEGF水平均显著高于对照组(P<0.01),且随着伤情的加重依次升高。经多元线性回归分析,三组颅脑损伤患者血清VEGF水平与入院时GCS评分和血清C-反应蛋白水平均显著相关(P<0.01)。入院时血清VEGF水平显著升高是中型和重型颅脑损伤预后不良的危险因素(P<0.05或P<0.01)。结论颅脑损伤后血清VEGF水平升高,可能参与脑损伤的炎症反应,其与伤情的严重程度呈显著性相关,可作为早期判断脑损伤患者预后指标。

Objective Through dynamic detection of the serum levels of vascular endothelial growth factor （VEGF） in patients with traumatic brain injury （TBI） dynamically to evaluate its correlations with sevrity of disease and prognosis. Methods The 53 patients with TBI and 20 healthy controls were enrolled in this study. Patients were classified into the mild（n=11）, the moderate（n=19）, and the severe （n=23） groups according to GCS（Glasgow Coma Scale） scores. Blood specimen were obtained from the healthy controls underwent physical examination, and from the TBI patients of the 3 groups on the 1st, 3rd and 7th day after onset respectively. Serum levels of VEGF were detected by enzyme-linked immunosorbent assay （ELISA）. Results Compared with control group, levels of VEGF in the mild, the moderate, and the severe TBI groups were increased significantly, and the VEGF levels were consistent with the degree of injury. By using the multivariate linear regression analysis, serum levels of VEGF were associated with GCS scores and serum C-reactive protine （P〈0.01）. Logistic regression analysis showed that serum VEGF level was an independent predictor for unfavorable outcome of the patients with moderate and severe TBI （P〈0.05 or P〈0.01）. Conclusion Serum level of VEGF is increased after TBI and maybe involved in inflammatory response of brain injury. It might be as the index for predicting the prognosis of patients with TBI. [Key words] Traumatic brain injury; Vascular endothelial growth factor; Inflammation; Prognosis