去骨瓣减压术后患者血清碱性成纤维细胞生长因子与血管内皮生长因子表达的临床意义  

Clinical significance of expression of serum basic fibroblast growth factor and vascular endothelial growth factor in patients after decompressive craniectomy

作　　者：汪新宇[1] 陈晓旭[1] 姜大宇[1] 李国栋[1] 董克辛[1] WANG Xin-yu CHEN Xiao-xu JIANG Da-yu et al(Department of Neurosurgery, Dalian City Friendship Hospital, Dalian 116001, China)

机构地区：[1]大连市友谊医院神经外科,116001

出　　处：《中国实用医药》2017年第25期19-21,共3页China Practical Medicine

基　　金：大连市卫生局课题项目(项目编号:WSJ/KJC-01-JL-01)

摘　　要：目的探讨早期颅骨修补手术指征及选择合适手术时机。方法选取去骨瓣减压术后患者42例,采用双抗体夹心酶联免疫吸附试验(ELISA)检测术前及术后15、30、45、60、75、90 d外周静脉血中碱性成纤维细胞生长因子(b FGF)、血管内皮生长因子(VEGF)水平。结果 42例患者术后15、30、45、60、75、90 d b FGF分别为(24.12±5.10)、(32.71±5.35)、(50.16±5.80)、(75.75±6.00)、(22.73±6.10)、(19.61±6.17)ng/L,均高于术前的(12.35±5.00)ng/L,差异有统计学意义(P<0.05)。术后30 d b FGF反应强度有变化,术后45 d增强明显,术后60 d进一步增加并达到高峰,然后开始下降。术后15、30、45、60、75、90 d VEGF均高于术前,差异有统计学意义(P<0.05)。术后15 d VEGF反应强度有变化,术后45 d达到高峰,此后开始逐渐下降。结论术后45 d后硬脑膜和肌皮瓣创面新生血管处于高峰期,如此时选择颅骨修补可能出现创面新生血管丰富、渗血较多,而术后75 d后b FGF、VEGF反应强度明显下降,此时手术可能取得较好效果。Objective To investigate the indications of early cranioplasty and the appropriate timing of operation.Methods A total of 42 patients with decompressive craniectomy were selected,and double antibody sandwich enzyme-linked immuno sorbent assay（ELISA） was used to detect levels of basic fibroblast growth factor（b FGF） and vascular endothelial growth factor（VEGF） in peripheral venous blood before operation and 15,30,45,60,75 and 90 days after operation.Results 42 patients had b FGF 15,30,45,60,75 and 90 days after operation respectively as（24.12±5.10）,（32.71±5.35）,（50.16±5.80）,（75.75±6.00）,（22.73±6.10） and（19.61±6.17） ng/L,which were all higher than（12.35±5.00） and（43.90±11.25） ng/L before operation,and the difference had statistical significance（P〈0.05）.The intensity of b FGF reaction changed at 30 days after operation.The intensity of b FGF was significantly increased at 45 days after operation and reached the peak at 60 days after operation,and then began to decrease.Patients had higher VEGF at 15,30,45,60,75 and 90 days after operation than before operation,and the difference had statistical significance（P〈0.05）.The intensity of VEGF reaction changed at 15 days after operation,and reached its peak at 45 days after operation,and then began to decrease.Conclusion The dura and muscle flap wound neovascularization is in the peak at 45 d after operation,and if the skull repair is performed at this time,the wound may be rich in new blood vessels and more oozing of blood.But the response intensity of b FGF and VEGF will decrease obviously 75 d after operation,and this time surgery may achieve good results.

关 键 词：碱性成纤维细胞生长因子 血管内皮生长因子 去骨瓣减压术 

分 类 号：R651.1[医药卫生—外科学]