血管内皮生长因子与急性硬膜外血肿严重程度的关系  

Relationship between VEGF and severity of acute epidural hematoma

作　　者：孙胜房[1] 李民涛 马会力[1] 贾竹亭[1] SUN Shengfang;LI Mintao;MA Huili;JIA Zhuting(First-aid Center,Binzhou Medical University hospital,Binzhou 256603,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院急救中心,山东滨州256603

出　　处：《滨州医学院学报》2021年第2期96-99,共4页Journal of Binzhou Medical University

基　　金：滨州医学院科技计划(BY2016KJ30)。

摘　　要：目的检测血管内皮生长因子(VEGF)在急性硬膜外血肿(EDH)患者血液中的表达情况,并探讨与其严重程度的关系。方法选取我院急诊科收入院的CT确诊为EDH并入院时检测VEGF的342例成人患者为研究对象,根据入院时检测的VEGF表达高低分为VEGF表达低、正常和高三组,入院时记录新的损伤严重程度评分(NISS),格拉斯哥昏迷量表(GCS),血肿体积和中线移位大小;出院时记录早期神经功能下降(END),手术方式,死亡人数和重症监护病房(ICU)及总住院时间。应用Pearson法分析不同VEGF分组之间VEGF水平与各指标之间的关系,方差分析计算VEGF水平与病死率的关系,非条件logistic回归分析病死的危险因素。结果342例EDH患者入院时VEGF平均值为(74.585±37.686)pg/mL。147例(43.0%)行手术治疗,出院时16例(4.7%)患者死亡。Pearson法显示VEGF与各指标无相关性,方差分析示VEGF降低与病死率有统计学意义的相关性(P<0.05),logistic回归分析示入院时NISS升高、GCS下降及VEGF降低是与病死率相关的危险因素。结论在入院早期,多数EDH患者血清VEGF值有所升高,少数降低。入院时NISS升高、GCS下降和VEGF降低是与病死率相关的危险因素。Objective To detect the expression of vascular endothelial growth factor(VEGF)in the blood of patients with acute epidural hematoma(EDH)and explore its relationship with severity.Methods Three hundred and forty-two adult patients admitted to the hospital with EDH whose VEGF values were detected were selected for research.Patients were divided into low,normal and high groups according to the VEGF values detected at admission.New injury severity score(NISS),Glasgow Coma Scale(GCS),hematoma volume,and midline shift were recorded at admission.Early neurological decline(END),surgical procedure,death toll,intensive care unit(ICU)and total hospital stay were recorded at discharge.Pearson correlation analysis was used to analyze the relationship between VEGF levels and various indicators among different VEGF groups.The relationship between VEGF levels and mortality was calculated by analysis of variance.Unconditional logistic regression analysis was used to determine the risk factors associated with mortality.Results Totally 342 patients with EDH were studied,and the mean VEGF at admission was(74.585±37.686)pg/mL.One hundred and forty-seven patients(43.0%)underwent surgery.Sixteen patients(4.7%)died before discharge.Pearson method showed no correlation between VEGF and each index.Analysis of variance showed statistically significant correlation between VEGF reduction and mortality(P<0.05).Logistic regression analysis showed that NISS increase and GCS decrease at admission and VEGF reduction were risk factors associated with mortality.Conclusion In the early phase of admission,the serum VEGF values of more patients with EDH increased,and a few cases decreased.NISS increase,GCS decrease and VEGF reduction during admission were risk factors for mortality.

关 键 词：血管内皮生长因子 硬膜外血肿 病死率 格拉斯哥昏迷量表 

分 类 号：R641[医药卫生—外科学]