颅脑损伤患者血清HIF-1α VEGF水平及与损伤程度和预后的关系  

Serum Levels of HIF-1α and VEGF in Patients with Craniocerebral Injury and Their Relationship with Severity Degree and Prognosis

作　　者：戴领[1] 卜莉[2] DAI Ling(Panzhihua Central Hospital of Sichuan Province,Sichuan Panzhihua 617067,China)

机构地区：[1]四川省攀枝花市中心医院急诊科,四川攀枝花617067 [2]北京航天总医院急诊科,北京100076

出　　处：《河北医学》2020年第1期84-88,共5页Hebei Medicine

基　　金：四川省卫生和计划生育委员会科研课题,(编号:16PJ169)

摘　　要：目的: 探讨颅脑损伤患者血清HIF-1α、VEGF水平表达与疾病损伤程度以及预后的关系。 方法: 选择2017年2月至2018年12月在攀枝花市中心医院收治的198例颅脑损伤患者作为研究组,并根据格拉斯哥昏迷量表(GCS)评分将颅脑损伤分为轻度组62例、中度组76、重度组60例。并根据治疗后3个月的日常生活能力分级将颅脑损伤分为例预后良好组140例和预后不良组58例。并选用同期体检健康者70例作为对照组。患者入院后的第1天、第3天、第7天采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测HIF-1α、VEGF水平表达,比较不同组HIF-1α、VEGF水平表达以及与预后的关系。 结果: 研究组血清HIF-1α、VEGF水平明显高于对照组(P<0.05);三组颅脑损伤患者各时间点血清HIF-1α、VEGF水平比较均有差异(P<0.001),重度组血清HIF-1α、VEGF水平在入院第1d、3d、7d均明显高于中度组、轻度组(重度组>中度组>轻度组,P<0.001);预后不良组血清HIF-1α、VEGF水平均明显高于预后良好组(P<0.001);采用Logistic回归分析,结果显示中度(OR=3.39,95%CI:2.66~4.32)、重度(OR=5.19,95%CI:3.89~6.92)、血清HIF-1α≥62.24ng/mL(OR=3.48,95%CI:2.47~4.90)、VEGF≥160.91pg/mL(OR=4.67,95%CI:2.81~7.76)为颅脑损伤患者预后的危险因素。 结论 :血清HIF-1α、VEGF水平在颅脑损伤患者中的表达水平升高,且在预后不良患者中表达水平升至更高,因此血清HIF-1α、VEGF水平与颅脑损伤患者的预后有重要关系。Objective: To investigate the serum levels of HIF-1α and VEGF in patients with craniocerebral injury and their relationship with severity degree and prognosis. Methods: 198 patients with craniocerebral injury (study group) and 70 cases of health examinees (control group) in Panzhihua Central Hospital from February 2017 to December 2018 were selected. The study group was re-divided into four subgroups according to the Glasgow Coma Scale (GCS) and post-treatment daily living ability, namely mild group (n=62), moderate group (n=76), severe group (n=60), good prognosis group (n=140) and poor prognosis group (n=58). The levels of HIF-1α and VEGF were detected by enzyme-linked immunosorbent assay (ELISA) on the 1st, 3rd and 7th day after admission, and their relationship with prognosis were compared. Results: The serum levels of HIF-1a and VEGF in the study group were significantly higher than those in the control group (P<0.05). The levels of serum HIF-1α and VEGF on the 1st, 3rd and 7th day after admission ranking in a descending order severe group, moderate group and mild group (P<0.001). The serum levels of HIF-1α and VEGF in the poor prognosis group were significantly higher than those in the prognosis group (P<0.001). Logistic regression analysis showed moderate degree (OR=3.39, 95%CI: 2.66~4.32), severe degree (OR=5.19, 95%CI: 3.89~6.92), serum HIF-1α≥62.24ng/ml (OR=3.48, 95%CI: 2.47~4.90), and VEGF≥160.91pg/ml (OR=4.67, 95%CI: 2.81~7.76) were risk factors for good prognosis in patients with craniocerebral injury. Conclusion: The levels of serum HIF-1 α and VEGF increased in patients with brain injury, and even higher in patients with poor prognosis. Therefore, the levels of serum HIF-1 α and VEGF have an important relationship with the prognosis of patients with brain injury.

关 键 词：颅脑损伤 HIF-1Α VEGF 预后 

分 类 号：R651.15[医药卫生—外科学]