Effect of Hif-1α/Vegf signal pathway activation on the condition of patients with basal ganglia hemorrhage
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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.
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 con-centration(OR=1.821,95％CI:1.119-2.965;P=0.016)were independent of END after acute ICH predictor.Serum HIF-1αconcentration(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 predict-ed 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-1αconcentration is better than that of serum VEGF.
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