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目的探讨EV71脑炎患儿血清和脑脊液(cerebrospinal fluid,CSF)中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)和血管细胞粘附分子-1(vascular cell adhesion molecule-1,VCAM-1)水平的变化及其临床意义。方法根据临床表现将患儿分为普通病例组、重症病例组(再分为重型组和危重型组)。并设立对照组。应用双抗体夹心ELISA法检测各组患儿血清和CSF中VEGF和可溶性血管细胞粘附分子-1(soluble vascular cell adhesion molecule-1,s VCAM-1)的水平。结果普通病例组血清和CSF中VEGF、s VCAM-1水平与对照组差异无统计学意义(均P>0.05)。重症病例组血清和CSF中VEGF、s VCAM-1水平均显著高于普通病例组和对照组,差异有统计学意义(均P<0.01)。危重型组血清和CSF中VEGF、s VCAM-1水平均显著高于重型组,差异有统计学意义(P<0.01或P<0.05);且二组血清和CSF中VEGF、s VCAM-1水平均显著高于对照组,差异有统计学意义(P<0.01或P<0.05)。重症病例组急性期血清和CSF中VEGF、s VCAM-1含量均显著高于恢复期和对照组,差异有统计学意义(均P<0.01)。重症病例组血清与CSF中VEGF、s VCAM-1均呈正相关(r=0.587、0.648,均P<0.01);普通病例组、对照组血清与CSF中VEGF、s VCAM-1均无相关性。结论 VEGF、VCAM-1可能参与EV71脑炎的发病机制,对EV71脑炎的病情严重性评估及预后判断有一定意义。
Objective To investigate the expression of vascular endothelial growth factor (VEGF) and vascular cell adhesion molecule-1 (VCAM-1) in serum and cerebrospinal fluid (CSF) Level changes and their clinical significance. Methods According to clinical manifestations, children were divided into common case group, severe case group (divided into severe group and severe group). And set up a control group. The levels of VEGF and soluble vascular cell adhesion molecule-1 (s VCAM-1) in serum and CSF were detected by double antibody sandwich ELISA. Results There was no significant difference in the levels of VEGF, s VCAM-1 in serum and CSF between the two groups (all P> 0.05). Serum and CSF levels of VEGF and s VCAM-1 in severe cases were significantly higher than those in normal cases and controls (all P <0.01). Serum and CSF of critically ill patients with VEGF, s VCAM-1 levels were significantly higher than the heavy group, the difference was statistically significant (P <0.01 or P <0.05); and serum VEGF and sVCAM-1 levels Were significantly higher than the control group, the difference was statistically significant (P <0.01 or P <0.05). Serum and CSF levels of VEGF and s VCAM-1 in severe cases were significantly higher than those in recovery and control groups (all P <0.01). There was a positive correlation between serum VEGF and sVCAM-1 in severe cases (r = 0.587,0.648, all P <0.01). There was no correlation between serum VEGF and sVCAM-1 in CSF and normal controls. Conclusions VEGF and VCAM-1 may be involved in the pathogenesis of EV71 encephalitis, which may be of great significance in evaluating the severity of EV71 encephalitis and prognosis.