动态检测急性脑梗死患者Hcy、EGF、VEGF的临床意义

目的:探讨动态检测同型半胱氨酸(Hcy)、表皮生长因子(EGF)、血管内皮生长因子(VEGF)水平在急性脑梗死患者中的临床意义。方法:109例急性脑梗死患者依据入院时经MRI或CT测量的脑梗死体积分为大、中、小梗死3组,并在入院第1、7、14天分别测定3组患者的血Hcy、EGF、VEGF水平。同时选择近期住院无新发脑梗死患者30例作为对照组。结果:与对照组比较,急性脑梗死患者第1、7和14天血清Hcy与VEGF水平均明显高于对照组(P<0.01),而血清EGF水平均显著低于对照组(P<0.05~P<0.01)。急性脑梗死患者大、中梗死组和第1、7和第14天Hcy、VEGF水平均明显高于小梗死组(P<0.01),而第1、7和第14天水平均显著低于小梗死组(P<0.01)。结论:Hcy、EGF、VEGF在急性脑梗死患者中呈动态变化并与脑梗死体积相关,联合检测对判断脑梗死的损伤程度和评价治疗效果有重要的临床意义。

The clinical significance of the dynamic detection of Hcy,EGF and VEGF in patients with acute cerebral infarction

Objective:Compared with the control group,the levels of serum Hcy and VEGF in 1,7 and 14 day in patients with acute cerebral infarction were significantly higher(P<0. 01),while the levels of serum EGF were significantly lower than those in control group(P<0. 05 ~P <0. 01 ). The levels of serum Hcy and VEGF in 1,7 and 14 d in large and medium infarction groups were significantly higher than those in small infarction group(P<0. 01),but the levels of serum EGF in 1,7 and 14 day in large and medium infarction groups were significantly lower than those in small infarction group(P<0. 01). Methods:One hundred and nine cases with acute cerebral infarction were divided into the large,medium and small infarction groups according to the infarct volume detected by MRI or CT at admission. The serum concentrations of Hcy,EGF and VEGF in three groups after 1,7 and 14 d of admission were detected. Thirty healthy people without acute cerebral infarction were set as the control group. Results:Compared with the control group,the levels of serum Hcy and VEGF in 1,7 and 14 day in patients with acute cerebral infarction were significantly higher( P<0. 01), while the levels of serum EGF were significantly lower than those in control group(P<0. 05~P<0. 01 ). The levels of serum Hcy and VEGF in 1,7 and 14 d in large and medium infarction groups were significantly higher than those in small infarction group(P<0. 01),but the levels of serum EGF in 1,7 and 14 day in large and medium infarction groups were significantly lower than those in small infarction group(P<0. 01). Conclusions:The dynamic changes of the serum Hcy,EGF and VEGF levels in patients with acute cerebral infarction are associated with the infarct volume. The combined detection has important clinical significance in determining of the damage and evaluating the therapeutic effects of cerebral infarction.