Dynamic Changes of Serum YKL-40 and VEGF in Elderly Patients with Acute Cerebral Infarction Treated with Hyperbaric Oxygen and the Correlation of Prognosis
Objective To investigate the changes of serum human cartilage glycoprotein 39(YKL-40)and vascular endothelial growth factor(VEGF)levels and the correlation of prognosis in hyperbaric oxygen comprehensive treatment in elderly acute cerebral infarction.Methods Fifty-one cases of elderly patients with acute cerebral infarction admitted to the Department of Neurology of the Zhengzhou Second People's Hospital from January 2019 to December 2022 were selected and divided into 23 cases in the control group and 28 cases in the hyperbaric oxygen therapy group according to the treatment modality of the patients.The control group received conventional treatment such as thrombolysis,improvement of microcirculation and nerve nutrition.The hyperbaric oxygen group was given conventional treatment along with hyperbaric oxygen therapy,hyperbaric oxygen therapy was administered at a chamber pressure of 0.2 MPa once a day,10 times for 1 course of treatment,2 courses of treatment.The National Institute of Health stroke scale was observed and analyzed before and after treatment,and the dynamic changes in serum YKL-40 and VEGF levels at different times(admission,4,7 and 14 days)and prognostic correlation were observed by hyperbaric oxygen therapy.Results The serum YKL-40 levels in the control group and hyperbaric group changed dynamically as the disease progressed,peaking at fourth day after onset and decreasing at seventh day(P＜0.05),and the hyperbaric group was lower than the control group(P＜0.05).The VEGF levels gradually increased as the disease progressed,peaking at seventh day after onset(P＜0.05),and the hyperbaric group was higher than the control group(P＜0.05).Improved patients in hyperbaric oxygen group were more than non-improved patients.The serum YKL-40 level was lower in the improved group than in the non-improved group on the 4th and 7th day of treatment(P＜0.05),and the serum VEGF level was higher in the improved group than that in the non-improved group on the 4th and 7 th day of treatment(P＜0.05).Correlation analysis showed that serum YKL-40 level was negatively correlated with short-term prognosis of patients with cerebral infraction(P＜0.05),and serum VEGF was positively correlated with short-term prognosis of patients with cerebral infraction(P＜0.05).Logistic regression analysis showed that VEGF(β=0.033,P=0.045)and YKL-40(β=-0.098,P=0.025)were independently associated with the prognosis of elderly patients with cerebral infarction after hyperbaric oxygen therapy.Conclusion Hyperbaric oxygen therapy effectively improves neurological deficits and reduces the inflammatory response of the patient's organism,and YKL-40 levels can be used as an indicator to evaluate the condition and judge the prognosis of patients with cerebral infarction after comprehensive hyperbaric oxygen therapy.
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