中国卒中杂志2019，Vol.14Issue(9)：856-864,9.DOI:10.3969/j.issn.1673-5765.2019.09.002
脑微出血影像学分类与血浆血管内皮生长因子水平及载脂蛋白E基因分型的关系研究
Relationship of Imaging Classification of Cerebral Microbleeds and Plasma Vascular Endothelial Growth Factor Level and Apolipoprotein E Phenotype
摘要
Abstract
Objective To investigate the relationship between the imaging classification of cerebral microbleeds (CMBs) and plasma vascular endothelial growth factor (VEGF) levels based on apolipoprotein E (ApoE) phenotype, to provide valuable biomarkers for the early warning screening of CMBs. Methods Patients with acute cerebral infarction who were admitted to the Huangdao Branch of the Affiliated Hospital of Qingdao University and Weihai Central Hospital of Qingdao University from August 2014 to August 2017 were selected. All the patients were divided into CMBs and non-CMBs according to the presence or absence of CMBs. The baseline data included gender, age, mini-mental state examination (MMSE) score, NIHSS score, hypertension, systolic blood pressure, diabetes, antihypertensive drugs, anticoagulation and antiplatelet agents and etc. With reference to the CMBs Anatomical Rating Scale, the CMBs were divided into deep CMBs, lobe CMBs, subtentorial CMBs, and mixed CMBs according to the distribution of CMBs. To facilitate the analysis, subtentorial CMBs were classified as deep CMBs and mixed CMBs were excluded. ApoE genotyping of all patients were measured using the ApoE genotyping Kit. Plasma VEGF level was measured by ELISA. After adjusting for the potential confounding factors, logistic regression analysis was used to analyze the relationship of plasma VEGF level and different imaging classification of CMBs. Results Ninety nine cases of CMBs were identified, including 7 cases with mixed CMBs who were excluded. Plasma VEGF levels in CMBs group was significantly higher than that in non-CMBs group (P=0.05). The plasma VEGF level in deep CMBs group was significantly higher than that in non-CMBs group ( P=0.009). High level of plasma VEGF was a risk factor for CMBs ( OR 1.59, 95% CI 1.02-2.47; P=0.05). In patients with deep CMBs, there was an interaction between plasma VEGF levels and ApoE genotype ( P=0.01). In patients with ApoE ε3/ε3, the adjusted OR of deep CMBs for each standard deviation (SD) increase in plasma VEGF levels was 0.90 (95% CI 0.49-1.20; P=0.73); in patients with ApoE ε2 or ε4, the adjusted OR of deep CMBs for each SD increase in plasma VEGF level was 2.83 (95% CI 1.31-6.10; P=0.008). Conclusions Deep CMBs are associated with the high level of plasma VEGF. The relation of plasma VEGF with CMBs may have ApoE genotype dependence.关键词
脑梗死/脑微出血/影像学/血管内皮生长因子Key words
[Key Words] Cerebral infarction/ Cerebral microbleed/ Imaging/ Vascular endothelial growth factor引用本文复制引用
白家赫,于永鹏,刘丽君,郑亚利,李鑫,谭兰..脑微出血影像学分类与血浆血管内皮生长因子水平及载脂蛋白E基因分型的关系研究[J].中国卒中杂志,2019,14(9):856-864,9.基金项目
国家自然科学基金项目(81400957)威海市自体免疫重点实验室开放基金项目(2017GGH11) （81400957）
