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目的:探讨动脉瘤性蛛网膜下腔出血(SAH)并发脑血管痉挛(CVS)与血清血管内皮生长因子(VEGF)表达的关系。方法:27例动脉瘤性SAH患者为试验组(SAH组),再依据是否并发不同程度CVS分为:无CVS亚组(11例),轻度CVS亚组(9例)、中度CVS亚组(4例)和重度CVS亚组(3例);另设10名健康体检者为对照组。采用ELISA法检测血清VEGF水平。结果:SAH各时间点各组血清VEGF水平为①SAH组发病第1天起即明显高于对照组;②无CVS组不增高。SAH后第1、3、5、7天时血清VEGF水平为①轻度CVS组与中度CVS组相同时间点比较,差异无统计学意义;②重度CVS组明显高于轻度和中度CVS组。SAH后出现脑梗死患者血清VEGF水平明显高于未出现脑梗死患者。结论:SAH后出现CVS患者和出现脑梗死的患者血清VEGF水平明显增高,血清VEGF水平能反映脑血管痉挛的程度。
Objective: To investigate the relationship between aneurysmal subarachnoid hemorrhage (SAH) complicated with cerebral vasospasm (CVS) and serum vascular endothelial growth factor (VEGF) expression. Methods: Twenty-seven patients with aneurysmal SAH were divided into experimental group (SAH group) and CVS group according to whether they were complicated by CVS or not: CVS subgroup (n = 11), mild CVS subgroup (n = 9) (4 cases) and severe CVS subgroup (3 cases). Another 10 healthy subjects were selected as the control group. Serum VEGF levels were measured by ELISA. Results: The serum levels of VEGF in each group were significantly higher than those in the control group on the first day after onset of SAH. ② No CVS was observed in the groups without CVS. The levels of serum VEGF in the 1st, 3rd, 5th, 7th day after SAH were ① mild CVS group and moderate CVS group at the same time point, the difference was not statistically significant; ② severe CVS group was significantly higher than mild and moderate CVS group . Serum VEGF levels in patients with cerebral infarction after SAH were significantly higher than those without cerebral infarction. CONCLUSIONS: Serum levels of VEGF in patients with CVS and those with cerebral infarction after SAH are significantly increased, and serum VEGF levels reflect the extent of cerebral vasospasm.