目的: 探讨缺氧诱导因子1α（hypoxia-inducible factor 1α,HIF-1α）/血管内皮生长因子（vascular endothelial growth factor ,VEGF）表达与脑基底节出血病情及预后的关系。方法: 选择2019年1月至2022年1月106名脑基底节出血患者为研究对象。使用用双抗夹心酶联免疫测量血清HIF-1α、VEGF的水平。通过多变量逻辑回归分析血清HIF-1α、VEGF水平与早期神经功能恶化（early neurologic deterioration,END）以及损伤后3个月不良预后之间的关系,并通过受试者工作特征曲线评估变量的预测能力。结果: 患者入院时血清HIF-1α、VEGF水平与入院NIHSS评分呈显著正相关（r=0.6267、0.8495,均P<0.001）。随着基线血肿大小的增加,入院血清HIF-1α、VEGF水平在急性脑出血（intracerebral hemorrhage,ICH）后显著升高（r=0.5352、0.6418,均P<0.001）。血清HIF-1α水平（OR=4.054,95%CI：1.368~12.009,P=0.012）和血清VEGF水平（OR=1.821,95%CI：1.119~2.965,P=0.016）是急性ICH后END的独立预测因子。血清HIF-1α水平（OR=4.721,95%CI：1.662~13.407,P=0.014）和血清VEGF水平（OR=2.198,95%CI：1.204~4.013,P=0.010）是急性ICH后预后较差的独立预测因子。血清HIF-1α水平预测急性脑出血患者END（AUC=0.7465,95%CI：0.6572~0.8178,P<0.001）和3个月预后（AUC=0.7744,95%CI：0.7072~0.8416,P<0.001）的能力高于血清VEGF水平（AUC=0.6882,95%CI：0.6113~0.7650,P<0.001;AUC=0.7025,95%CI：0.6270~0.7780,P<0.001）。结论: 血清HIF-1α和VEGF水平与ICH后3个月的END和不良预后独立相关,血清HIF-1α水平的预后价值高于血清VEGF。
Abstract
Objective To investigate the relationship between the expression of hypoxia-inducible factor 1α (HIF-1α) /vascular endothelial growth factor (VEGF) and the condition and prognosis of basal ganglia hemorrhage. Methods A total of 106 patients with basal ganglia hemorrhage from January 2019 to January 2022 were selected as the research subjects. The concentrations of serum HIF-1α and VEGF were measured by sandwich enzyme-linked immunosorbent assay with double antibodies. The associations between serum HIF-1α and VEGF concentrations and early neurological deterioration and poor prognosis 3 months after injury were analyzed by multivariate logistic regression, and the predictive power of the variables was assessed by receiver operating characteristic curve. Results The serum HIF-1α and VEGF concentrations at admission were significantly positively correlated with the admission NIHSS score (r=0.6267, 0.8495, both P<0.001). With the increase of baseline hematoma size, the serum HIF-1α and VEGF concentrations were significantly increased after acute ICH (r=0.5352, 0.6418, both P<0.001). Serum HIF-1α concentration (OR=4.054, 95%CI: 1.368-12.009; P=0.012) and serum VEGF concentration (OR=1.821, 95%CI: 1.119-2.965; P=0.016) were independent of END after acute ICH predictor. Serum HIF-1α concentration (OR=4.721, 95%CI: 1.662-13.407; P=0.014) and serum VEGF concentration (OR=2.198, 95%CI: 1.204-4.013, P=0.010) were associated with worse prognosis after acute ICH independent predictors. Serum HIF-1α concentration predicted early neurological deterioration (AUC=0.746, 95%CI: 0.6572-0.8178, P<0.001) and 3-month prognosis (AUC=0.7744, 95%CI: 0.7072-0.8416; P<0.001) was better than the serum VEGF concentrations (AUC=0.6882, 95%CI: 0.6113-0.7650; P<0.001 and AUC=0.7025, 95%CI: 0.6270-0.7780; P<0.001). Conclusion Serum HIF-1α and VEGF concentrations are independently associated with END and poor prognosis 3 months after ICH. In addition, the prognostic value of serum HIF-1α concentration is better than that of serum VEGF.
关键词
缺氧诱导因子1α /
血管内皮生长因子 /
基底节出血 /
病情 /
预后
Key words
hypoxia-inducible factor 1α /
vascular endothelial growth factor /
basal ganglia hemorrhage /
condition /
prognosis
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基金
新疆维吾尔自治区卫生健康委员会科研基金项目“Hif-1α/Vegf信号通路活化对基底节出血患者病情的影响”（20210271）
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