摘要
目的探究急性缺血性脑卒中(acute ischemic stroke,AIS)患者血管内介入治疗后血管再通率及与血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)、D-二聚体(D-dimer,D-D)、可溶性生长刺激表达基因2蛋白(soluble growth-stimulated expressed gene 2 protein,sST2)的关系。方法选取2019年4月至2023年6月南方医科大学第三附属医院神经内科收治的153例AIS患者作为研究对象。根据血管内介入治疗后血管再通情况将患者分为血管再通失败组(n=22)和血管再通成功组(n=131)。比较两组血管内介入治疗前血清VEGF、D-D、sST2水平,并查阅电子病历、手术记录等统计患者其他临床资料,采用多因素Logistic回归分析探究AIS患者血管内介入治疗后血管再通与血清VEGF、D-D、sST2的关系;绘制受试者工作特征(receive operating characteristic,ROC)曲线分析血清VEGF、D-D、sST2对AIS患者血管内介入治疗血管再通失败的预测价值。结果153例患者血管再通率为85.62%,血管再通失败组患者VEGF水平低于血管再通成功组,D-D、sST2水平高于血管再通成功组,差异有统计学意义(P<0.05);两组入院时美国国立卫生研究院卒中量表(National Institutes ofHeahh Stroke Scale,NIHSS)评分比较,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,VEGF、D-D为AIS患者血管内介入治疗血管再通的影响因素;ROC曲线分析血清VEGF、D-D预测AIS患者血管内介入治疗血管再通失败的曲线下面积为0.952、0.917,其中VEGF的曲线下面积最高,以247.0 pg/mL为截断值,其预测AIS患者血管内介入治疗血管再通失败的敏感度为95.45%、特异度为87.79%。结论VEGF、D-D、sST2水平在血管内介入治疗血管再通成功与失败AIS患者中存在显著差异,将VEGF、D-D水平作为辅助指标对AIS患者进行检测,或可有效预测AIS患者血管再通失败风险。
Objective To investigate the vascular recanalization rate in patients with acute ischemic stroke(AIS)after endovascular intervention and its relationship with vascular endothelial growth factor(VEGF),D-dimer(D-D)and soluble growth stimulating gene 2 protein(sST2).Methods A total of 153 AIS patients admitted to the Department of Neurology at the Third Affiliated Hospital of Southern Medical University from April 2019 to June 2023 were selected as the study subjects.They were divided into failed vascular recanalization group(n=22)and successful vascular recanalization group(n=131)according to the situation of vascular recanalization after endovascular intervention.Serum VEGF,D-D and sST2 levels in the two groups before endovascular intervention were compared.Other clinical data were collected through electronic medical records and surgical records.Multivariate logistic regression analysis was used to explore the relationship between vascular recanalization and serum VEGF,D-D,and sST2 in AIS patients after endovascular intervention.The receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum VEGF,D-D,and sST2 for vascular recanalization failure in AIS patients after endovascular intervention.Results The vascular recanalization rate in this study was 85.62%.VEGF level in the failed vascular recanalization group was lower than that in the successful vascular recanalization group,and the levels of D-D and sST2 were higher than those in the successful vascular recanalization group,with statistically significant differences(P<0.05).There was a statistically significant difference in the National Institutes of Health Stroke Scale(NIHSS)score at admission between the two groups(P<0.05).Multivariate logistic regression analysis showed that VEGF and D-D were factors influencing vascular recanalization in AIS patients after endovascular intervention.ROC curve analysis showed that the areas under the curve of serum VEGF and D-D for predicting vascular recanalization failure in AIS patients after endovascular intervention were 0.952 and 0.917.The area under the curve of VEGF was larger.When the cut-off value was 247.0 pg/ml,its sensitivity and specificity for predicting vascular recanalization failure were 95.45%and 87.79%.Conclusions There are significant differences in the levels of VEGF,D-D and sST2 between AIS patients with successful and failed vascular recanalization after endovascular intervention.Detecting VEGF and D-D levels in AIS patients as auxiliary indices may effectively help to predict their risk of vascular recanalization failure.
作者
谢灿滔
李莹
陆靖
杨灿洪
吕田明
XIE Cantao;LI Ying;LU Jing;YANG Canhong;LYU Tianming(Department of Neurology,the Third Affiliated Hospital of Southern Medical University,Guangzhou,Guangdong 510630,China;Department of Neurology,the Third Affiliated Hospital of Guangdong Pharmaceutical University/Guangzhou Fosun Chancheng Hospital of Guangdong Pharmaceutical University,Guangzhou,Guangdong 510000,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期75-80,共6页
Chinese Journal of Neurosurgical Disease Research
基金
广东省自然科学基金项目(2021A1515010006)。
