血VEGF、SDF-1、MMP-9和HMGB1水平与烟雾病患者颅内出血的关系

Relationship between serum VEGF,SDF⁃1,MMP⁃9 and HMGB1 levels and intracranial hemorrhage in MMD patients

目的分析血管内皮生长因子(VEGF)、基质衍生因子-1(SDF-1)、基质金属蛋白酶-9(MMP-9)和高迁移率族蛋白1(HMGB1)水平与烟雾病(MMD)患者颅内出血的关系。方法选取2017年2月至2020年2月本院收治的90例MMD患者为研究对象,根据有无出血分为出血组(n=50)和无出血组(n=40),并选取同期于本院进行体检的40例健康者作为对照组,根据超声检查结果将颅内出血患者分为轻度颅内出血组(n=32)和重度颅内出血组(n=18),检测血清VEGF、SDF-1、MMP-9和HMGB1水平,并分析VEGF、SDF-1、MMP-9水平与HMGB1的相关性。结果出血组血清VEGF、SDF-1、MMP-9和HMGB1水平均高于无出血组和对照组,差异具有统计学意义(P<0.05),无出血组血清VEGF、SDF-1、MMP-9和HMGB1水平均高于对照组,差异具有统计学意义(P<0.05);重度颅内出血组血清VEGF、SDF-1、MMP-9和HMGB1水平均高于轻度颅内出血组,差异具有统计学意义(P<0.05);ROC曲线分析显示,VEGF、SDF-1、MMP-9和HMGB1水平联合检测MMD的敏感度、阳性预测值及阴性预测值均高于单独检测(P<0.05);Spearman相关分析显示,血清VEGF-C、SDF-1、MMP-9水平与HMGB1呈正相关性(P<0.05)。结论血清VEGF、SDF-1、MMP-9和HMGB1水平与MMD发生、发展密切相关,可能是引起颅内出血的重要机制。

Objective To analyze the relationship between vascular endothelial growth factor(VEGF),stromal derived factor⁃1(SDF⁃1),matrix metalloproteinase⁃9(MMP⁃9)and high mobility group protein 1(HMGB1)levels and intracranial hemorrhage in patients with moyamoya disease(MMD).Meth⁃ods 90 cases of MMD patients admitted to our hospital from February 2017 to February 2020 were selected as the research object,according to the presence of hemorrhage were divided into bleeding group(n=50)and no hemorrhage group(n=40),and in the same period in our hospital for medical examination of 40 cases of healthy subjects as the control group,at the same time,according to the results of ultrasound to intracranial hem⁃orrhage patients were divided into the mild group(n=32)and the intracerebral haemorrhage severe intracranial hemorrhage group(n=18),detection of serum VEGF,SDF⁃1,MMP⁃9 and HMGB1 level,The correlation be⁃tween VEGF,SDF⁃1 and MMP⁃9 levels and HMGB1 was analyzed.Results The serum levels of VEGF,SDF⁃1,MMP⁃9 and HMGB1 in the bleeding group were all higher than those in the non⁃bleeding group and the control group,The difference was statistically significant(P<0.05).The serum levels of VEGF,SDF⁃1,MMP⁃9 and HMGB1 in the non⁃bleeding group were all higher than those in the control group.The difference was statis⁃tically significant(P<0.05).The serum levels of VEGF,SDF⁃1,MMP⁃9 and HMGB1 in the severe intracranial hemorrhage group were all higher than those in the mild intracranial hemorrhage group.The difference was sta⁃tistically significant(P<0.05).ROC curve analysis showed that the sensitivity,positive predictive value and negative predictive value of MMD detected by VEGF,SDF⁃1,MMP⁃9 and HMGB1 levels were all higher than those detected by single test(P<0.05).Spearman correlation analysis showed that serum VEGF,SDF⁃1 and MMP⁃9 levels were positively correlated with HMGB1(P<0.05).Conclusion Serum levels of VEGF,SDF⁃1,MMP⁃9 and HMGB1 are closely related to the occurrence and development of MMD,and may be an important mechanism causing intracranial hemorrhage.