慢性硬脑膜下血肿患者血管内皮生长因子和血管紧张素水平的变化及其意义  

Changes and significance of vascular endothelial growth factor and angiotensin levels in patients with chronic subdural hematoma

作　　者：刘红威 张师 Liu Hongwei;Zhang Shi(Zhengzhou ADICON Clinical Laboratories,Inc.,Zhengzhou,Henan 450000,China;Laboratory Department,Chinese Medicine Hospital of Puyang,Puyang,Henan 457000,China)

机构地区：[1]郑州艾迪康医学检验所临床实验室,河南郑州450000 [2]濮阳市中医医院检验科,河南濮阳457000

出　　处：《感染、炎症、修复》2024年第3期209-213,共5页Infection Inflammation Repair

摘　　要：目的:分析血管内皮生长因子(VEGF)和血管紧张素(Ang)在慢性硬脑膜下血肿(CSDH)中的水平变化及其意义。方法:选取2022年1月至2024年1月在濮阳市中医医院就诊且标本送检至郑州艾迪康医学检验所进行检测的78例CSDH患者设为观察组,并选取在濮阳市中医医院体检并将标本送至同一医学检验所进行检测的50名健康者作为对照组。观察组均进行手术治疗,术后3个月根据有无复发分为复发组(n=10)和未复发组(n=68),观察组检测血肿液和血液中VEGF、AngⅠ、AngⅡ水平,对照组检测血清VEGF和血浆AngⅠ、AngⅡ水平,多因素Logistic回归分析影响CSDH术后复发的因素,绘制受试者工作特征(ROC)曲线,分析VEGF、AngⅠ、AngⅡ水平对CSDH复发的预测价值。结果:观察组中,血肿液中VEGF、AngⅡ水平显著高于血清VEGF和血浆AngⅡ水平,血肿液中AngⅠ水平显著低于血浆AngⅠ水平(P<0.05);观察组血清VEGF和血浆AngⅡ水平显著高于对照组,血浆AngⅠ水平显著低于对照组(P<0.001)。CSDH患者复发组与未复发组血肿液中VEGF、AngⅡ水平显著高于血清VEGF和血浆AngⅡ水平,血肿液中AngⅠ水平显著低于血浆AngⅠ水平(P<0.05);复发组血肿液中VEGF、AngⅡ水平显著高于未复发组,血肿液中AngⅠ水平显著低于未复发组(P<0.05),两组血清VEGF和血浆AngⅠ、AngⅡ水平比较差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,血肿液中VEGF、AngⅡ水平升高和AngⅠ水平降低是术后CSDH复发的危险因素(P<0.05)。ROC曲线分析显示,血肿液中VEGF、AngⅠ、AngⅡ水平联合预测CSDH复发的敏感度为90.00%、特异度为87.93%、AUC为0.907,均高于3个指标单独预测的结果(P<0.05)。结论:CSDH患者血肿液中VEGF和AngⅡ水平呈高表达,AngⅠ呈低表达,且三指标与CSDH复发有关,三者联合检测对CSDH复发具有较高的预测价值,值得临床推广应用。Objective:To analyze the levels and significance of vascular endothelial growth factor(VEGF)and angiotensin(Ang)in chronic subdural hematoma(CSDH).Methods:Seventy-eight patients with CSDH who received treatment in Chinese Medicine Hospital of Puyang from January 2022 to January 2024 and sent their specimens to Zhengzhou Adicon Medical Laboratory were selected as the observation group.Meanwhile,50 healthy subjects who underwent physical examination in Chinese Medicine Hospital of Puyang and sent the specimens to the same medical laboratory were selected as the control group.All patients included in the observation group were treated with operation.According to the recurrence status 3 months after operation,the patients were divided into recurrence group(n=10)and non-recurrence group(n=68).VEGF,AngⅠand AngⅡlevels in hematoma fluid and blood were detected in the observation group,also serum VEGF and plasma AngⅠand AngⅡlevels were detected in the control group.Multivariate logistic regression analysis was performed to analyze the factors affectinging the recurrence of CSDH after operation.ROC curves were drawn to analyze the predictive value of VEGF,AngⅠand AngⅡlevels for recurrence of CSDH.Results:For the observation group,the levels of VEGF and AngⅡin hematoma fluid were higher than serum VEGF and plasma AngⅡlevels.AngⅠlevel in hematoma fluid was significantly lower than plasma AngⅠlevel(P<0.05).Serum VEGF and plasma AngⅡlevels in the observation group were significantly higher than those in the control group,and plasma AngⅠlevels were significantly lower than those in the control group(P<0.05).For both the recurrence group and the non-recurrence group,the levels of VEGF and AngⅡin hematoma fluid were significantly higher than serum VEGF and plasma AngⅡlevels.The level of AngⅠin hematoma fluid was significantly lower than plasma AngⅠlevel(P<0.05).The levels of VEGF and AngⅡin hematoma fluid of the recurrence group were higher than those of the non-recurrence group,and the level of

关 键 词：慢性硬脑膜下血肿 血管内皮生长因子 血管紧张素-1 血管紧张素-2 

分 类 号：R651[医药卫生—外科学]