血清VEGF、FGF、PLGF水平变化与ACI患者NIHSS评分关系及临床意义

The relationship and clinical significance between changes in serum VEGF,FGF,PLGF levels and NIHSS scores in ACI patients

目的:探讨血清血管内皮生长因子(VEGF)、成纤维细胞生长因子(FGF)、胎盘生长因子(PLGF)水平变化与急性脑梗死(ACI)患者美国国立卫生院卒中量表(NIHSS)评分关系及临床意义。方法:选取2021年4月-2022年8月我院收治的129例ACI患者为研究对象,根据入院时NIHSS评分将患者分为轻度组(46例)、中度组(58例)、重度组(25例)。比较三组入院时血清VEGF、FGF、PLGF水平,比较不同脑梗死灶体积、不同预后患者入院时血清VEGF、FGF、PLGF水平,分析入院时血清VEGF、FGF、PLGF水平与梗死灶体积、NIHSS、改良Rankin量表(mRS)评分的相关性及联合诊断价值,并分析其危险度。结果:入院时血清VEGF、FGF、PLGF水平比较:轻度组<中度组<重度组(P<0.05),小梗死灶<中梗死灶<大梗死灶(P<0.05);入院时,预后不良患者血清VEGF、FGF、PLGF水平比预后良好患者高(P<0.05);入院时血清VEGF、FGF、PLGF水平与梗死灶体积、NIHSS评分、mRS评分均呈正相关(P<0.05);入院时血清VEGF、FGF、PLGF水平联合预测ACI患者预后不良的AUC大于各单独指标(P<0.05);入院时血清VEGF、FGF、PLGF高水平患者预后不良的危险度是低水平的4.566、4.025、3.331倍(P<0.05)。结论:血清VEGF、FGF、PLGF水平与ACI患者NIHSS评分密切相关,可作为临床诊断病情、评估预后的有效指标。

Objective:To explore the relationship and clinical significance between changes in serum levels of vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),placental growth factor(PLGF),and the National Institutes of Health Stroke Scale(NIHSS)scores in patients with acute cerebral infarction(ACI).Methods:A total of 129 ACI patients admitted to Our Hospital from April 2021 to August 2022 were selected as the study subjects.According to the NIHSS score at admission,the patients were divided into mild group(46 cases),moderate group(58 cases),and severe group(25 cases).Compare the levels of serum VEGF,FGF,and PLGF at admission among three groups,and compare the levels of serum VEGF,FGF,and PLGF at admission among patients with different infarct volumes and prognosis.Analyze the correlation and joint diagnostic value of serum VEGF,FGF,and PLGF levels at admission with infarct volume,NIHSS,and Modified Rankin Scale(mRS)scores,and analyze their risk.Results:Comparison of serum VEGE,FGF,and PLGF levels at admission:mild group<moderate group<severe group(P<0.05),small infarction<medium infarction<large infarction(P<0.05);At admission,the serum levels ofVEGF,FGF,and PLGF in patients with poor prognosis were higher than those in patients with good prognosis(P<0.05);The levels of serum VEGF,FGF,and PLGF at admssion were positively correlated with infarct volume,NIHSS score,and mRS score(P<0.05);The combination of serum VEGF,FGF,and PLGF levels at admission predicted a higher AUC for poor prognosis in ACI patients compared to individual indicators(P<0.05);The risk of poor prognosis in patients with high levels of serum VEGF,FGF,and PLGF at admission is 4.566,4.025,and 3.331 times higher than those with low levels(P<0.05).Conclusion:The levels of serum VEGF,FGF,and PLGF are closely related to the NIHSS score in ACI patients,and can be used as effective indicators for clinical diagnosis and prognosis evaluation.