Changes and significance of vascular endothelial growth factor and angiotensin levels in patients with chronic subdural hematoma
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,Ang Ⅰand Ang Ⅱ levels in hematoma fluid and blood were detected in the observation group,also serum VEGF and plasma Ang Ⅰ and Ang Ⅱ levels 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,Ang Ⅰ and Ang Ⅱ levels for recurrence of CSDH.Results:For the observation group,the levels of VEGF and Ang Ⅱ in hematoma fluid were higher than serum VEGF and plasma Ang Ⅱ levels.Ang Ⅰ level in hematoma fluid was significantly lower than plasma Ang Ⅰ level(P＜0.05).Serum VEGF and plasma Ang Ⅱ levels in the observation group were significantly higher than those in the control group,and plasma Ang Ⅰ levels 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 Ang Ⅱ in hematoma fluid were significantly higher than serum VEGF and plasma Ang Ⅱ levels.The level of Ang Ⅰ in hematoma fluid was significantly lower than plasma Ang Ⅰ level(P＜0.05).The levels of VEGF and Ang Ⅱ in hematoma fluid of the recurrence group were higher than those of the non-recurrence group,and the level of Ang Ⅰ in hematoma fluid was lower than that of non-recurrence group(P＜0.05).There were no statistically significant differences in serum VEGF and plasma Ang Ⅰ and Ang Ⅱlevels between the two groups(P＞0.05).Multivariate logistic regression analysis showed that increased of VEGF and Ang Ⅱin hematoma fluid,and decreased Ang Ⅰwere independent risk factors for recurrence of CSDH(P＜0.05).ROC curve analysis showed that levels of VEGF,Ang Ⅰand Ang Ⅱin hematoma fluid combination predicted CSDH recurrence with a sensitivity of 90.00%,specificity of 87.93%and AUC of 0.907,which were higher than the results predicted by the three indexes alone(P＜0.05).Conclusions:The levels of VEGF and Ang Ⅱare highly expressed in the hematoma fluid of patients with CSDH,while Ang Ⅰ levels are low.The three indexes are related to recurrence of CSDH.The combined detection of the three indexes has high value in predicting the recurrence of CSDH,and is worthy of clinical promotion and application.
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