急性脑梗死患者血清VEGF、PEDF表达及其比值的变化和临床意义

Changes and significance of serum VEGF,PEDF,VEGF/PEDF ratio in acute ischemic stroke patients

目的探讨急性脑梗死患者血清中血管内皮生长因子(VEGF)、色素上皮衍生因子(PEDF)的表达以及其比值的动态变化,并探讨其临床意义。方法采用前瞻性对照实验的研究方法分为脑梗死组和正常对照组,对新诊断的41例急性脑梗死患者入院第1、3、7、14、28天应用双抗体夹心酶联免疫吸附分析法(ELISA)检测血清PEDF、VEGF浓度并计算VEGF/PEDF的比值变化,健康体检者作为正常对照组。结果急性脑梗死患者血清VEGF浓度随病程逐渐增高,第7天达到最高浓度(214.72±55.95)ng/L,与对照组比较,差异有统计学意义(t=2.439,P<0.05)。而急性脑梗死组血清PEDF浓度在入院后第1天最低(28.77±8.60)ng/L,与对照组比较差异有统计学意义(t=2.063,P<0.05),随病程时间延长逐渐提高,第14天接近健康人正常水平。急性脑梗死组患者发病第1、3、7天血清VEGF/PEDF比值分别为7.48±1.98、7.86±2.83、7.39±2.18,均高于对照组5.93±1.99,差异有统计学意义(分别t=3.63,P<0.001;t=3.68,P<0.001;t=3.24,P<0.01)。结论 VEGF/PEDF比值可以作为诊断急性脑梗死的一个检测指标,血清VEGF、PEDF浓度及其比值变化在急性脑梗死患者发病过程中有重要临床意义。

Objective To investigate the changes of serum vascular endothelial growth factor （ VEGF）, pigment epitheli- um-derived factor（PEGF） and VEGF/PEDF ratio in patients with acute ischemic stroke, and to evaluate their effects and possible clinical application in diagnosis and treatment of acute ischemic stroke. Methods Total 41 patients with acute ischemic stroke were included in our study, with 45 healthy adults as control. The enzyme-linked immunosorbent assay （ELISA） was used to detect the expression of PEDF and VEGF in sera of days 1,3,7,14 and 28 after the subjects were hospitalized. Results The VEGF expression in patients＇ sera increased during the 28-day-long observation after hospital- ization. It reached to its peak at day 7 post-stroke （ 214.72 ± 55.95 ） ng/L, which was significantly increased when compared to the control group（ t = 2. 439 ,P 〈 0.05 ）. Meanwhile ,the PEDF expression in patients＇ sera was significantly lower than the control group at the day hospitalized [ （ 28.77 ± 8.60） ng/L, （ 34.63 ± 16.21 ） ng/L, respectively ; t = 2. 063,P 〈 0. 05 ） ]. After, the expression level of PEDF in patients＇ sera increased gradually, and reached to a relatively high level at post-stroke day 14. There was no significant difference of serum VEGF and PEDF between the patients and control groups at other time points detected than the days 1 and 7 after hospitalization （ P 〉 0.05 ）. The ratios of serum VEGF/PEDF in patients group were 7.48 ± 1.98,7.86 ± 2. 83,7.39 ± 2. 18 at days 1,3,7,14 and 28 after acute ischemic stroke. The VEGF/PEDF ratios of all time points detected other than day 28 were higher than the control group （5.93 ± 1.99）. The statistical analysis showed that from post-stroke day 1 to day 7, the serum VEGF/PEDF ratio was significantly higher than the control group （ t = 3.63,P 〈 0. 001 ; t = 3.68, P 〈 0. 001 ; t = 3.24, P 〈 0. O1 ; respectively）, while no significant difference was found between two groups for post-stroke day 14 and 28 （ P 〉 O. 05 ）. Conclusion VEGF/PEDF ratio could be served as a diagnostic marker of acute ischemic stroke, serum VEGF, PEDF and VEGF/PEDF ratio might play an important role in the pathological process of acute ischemie stroke.