血管内皮生长因子、Toll样受体2与急性缺血性脑卒中颈动脉内膜中层增厚的相关性分析

A correlation analysis of vascular endothelial growth factor,toll-like receptor 2 and carotid intima-media thickening in acute ischemic stroke

目的分析血管内皮生长因子(VEGF)、Toll样受体2(TLR2)与急性缺血性脑卒中颈动脉内膜中层(IMT)增厚的关系。方法选取本院收治的急性缺血性脑卒中患者296例,根据颈动脉IMT超声结果分为IMT增厚组(n=205)和IMT正常组(n=91)。比较两组血清VEGF、TLR2水平,分析VEGF、TLR2水平与急性缺血性脑卒中颈动脉IMT增厚的相关性,采用受试者工作曲线(ROC)获取VEGF、TLR2水平诊断急性缺血性脑卒中颈动脉IMT增厚的最佳临界值,分析缺血性脑卒中颈动脉IMT增厚的影响因素。结果IMT增厚组IMT值大于IMT正常组(P<0.05),ROC曲线显示其曲线下面积为0.694,约登指数最大时的IMT值为1.046 mm;IMT增厚组患者血清VEGF、TLR2水平低于IMT正常组(P<0.05);血清VEGF、TLR2水平与急性缺血性脑卒中颈动脉IMT增厚呈负相关(P<0.05);VEGF临界值为383.04 ng/ml时,约登指数最大为0.384;TLR2临界值为4342.73 pg/ml时,约登指数最大为0.617。年龄≥60岁、有吸烟史、糖尿病病史、高尿酸血症病史、血清VEGF≤383.04ng/ml、血清TLR2≤4342.73 pg/ml为急性缺血性脑卒中颈动脉IMT增厚的独立危险因素(P<0.05)。结论除传统因素外,血清VEGF、TLR2水平也是急性缺血性脑卒中患者颈动脉IMT增厚的危险因素,且VEGF、TLR2水平与颈动脉IMT增厚均呈负相关。

Objective To analyze the relationship between the vascular endothelial growth factor(VEGF),toll-like receptor 2(TLR2)and the carotid intima-media thickness(IMT)thickening in acute ischemic stroke.Methods We selected 296 patients with acute ischemic stroke admitted to our hospital.The patients were divided into IMT thickening group(n=205)and IMT normal group(n=91)according to IMT ultrasound results of carotid artery.The levels of serum VEGF and TLR2 were compared between the two groups,and the relationship between the VEGF and TLR2 levels and the IMT thickening of acute ischemic stroke was analyzed.The best critical values of VEGF and TLR2 levels in diagnosing IMT thickening of acute ischemic stroke were obtained by receiver operating curve(ROC)analysis.The influencing factors of carotid artery IMT thickening in ischemic stroke were analyzed.Results The average IMT value of the IMT thickening group was significantly higher than that of the IMT normal group(P<0.05).ROC analysis showed that the area under the curve(AUC)was 0.694,and the IMT value of the maximum Youden index was 1.046 mm.Serum VEGF and TLR2 levels in the IMT thickening group were significantly lower than those in the IMT normal group(P<0.05).Serum VEGF and TLR2 levels were negatively correlated with IMT thickening of carotid artery after acute ischemic stroke(P<0.05).ROC curve analysis showed that when the critical value of VEGF was 383.04 ng/ml,the maximum Jordan index was 0.384 and when the critical value of TLR2 was4342.73 pg/ml,the maximum Jordan index is 0.617.Age≥60 years old,smoking history,diabetes history,hyperuricemia history,serum VEGF≤383.04 ng/ml and serum TLR2≤4342.73 pg/ml were independent risk factors for carotid IMT thickening in acute ischemic stroke(P<0.05).Conclusion In addition to traditional factors,serum VEGF and TLR2 levels also are risk factors for carotid IMT thickening in patients with acute ischemic stroke.VEGF and TLR2 levels are negatively correlated with carotid IMT thickening.