Abstract：【Objective】 To explore the value of serum vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1 (SDF-1) combined with clinical characteristics in predicting the short-term prognosis of patients with moyamoya disease. 【Methods】A total of 145 patients with moyamoya disease treated in our hospital from January 2018 to January 2020 were selected as the research object. All patients underwent vascular reconstruction. According to the prognosis one month after operation, the patients were divided into good prognosis group (107 cases) and poor prognosis group (38 cases). The clinical data of all patients were collected, including gender, age, body mass index (BMI), clinical manifestations (blood type, blood type), hypertension or diabetes, smoking or drinking, preoperative ischemia or bleeding, recurrence of stroke, and Suzuki staging. The levels of serum VEGF, SDF-l and the score of modified Rankin Scale (mRS) were recorded 7 days after operation. ROC curve was used to analyze the value of VEGF, SDF-1 and mRS score in predicting the short-term prognosis of patients with moyamoya disease. Unconditional logistic stepwise regression was used to analyze the risk factors of poor short-term prognosis of patients with moyamoya disease; The value of combining multiple risk factors in predicting poor short-term prognosis in patients with moyamoya disease was analyzed by consistency.【Results】Univariate analysis showed that the proportion of patients with hypertension, diabetes, alcohol consumption, preoperative ischemia or hemorrhage and recurrence of stroke was higher than those with good prognosis. The mRS score of poor prognosis group was higher, while the level of VEGF and SDF-1 was lower. The difference was statistically significant (P<0.05). ROC analysis showed that VEGF ≤ 188.065 pg/mL, SDF-1 ≤ 218.370 pg/mL and mRS score ≥3.130 were the best cutoff values for poor short-term prognosis in patients with moyamoya disease (P<0.05); Multivariate Logistic regression analysis showed that hypertension, diabetes, alcohol consumption, preoperative ischemia or hemorrhage, stroke relapse, VEGF < 188.065 pg/mL, SDF-1 < 218.370 pg/mL, mRS score greater than 3.130 were the risk factors for short-term prognosis of patients with moyamoya disease (P<0.05). By consistency analysis, the sensitivity of multiple risk factors combined to predict the poor short-term prognosis of moyamoya disease patients was 0.921, the specificity was 0.953, and the accuracy was 0.945 (κ=0.860). 【Conclusion】 VEGF ≤ 188.065 pg/mL, SDF-1≤218.370 pg/mL and mRS score ≥ 3.130 are the best cutoff values for poor short-term prognosis in patients with moyamoya disease. In addition, hypertension or diabetes mellitus, alcohol consumption, preoperative ischemia or hemorrhage, recurrence of stroke are risk factors for short-term prognosis. The levels of serum VEGF and SDF-1 combined with multiple risk factors have good predictive value for the short-term prognosis of patients with moyamoya disease.
叶楠, 李耀增, 刘蕊. 血清VEGF、SDF-l水平联合临床特征预测烟雾病患者短期预后的价值[J]. 医学临床研究, 2021, 38(11): 1650-1654.
YE Nan, LI Yao-zeng, LIU Rui. Value of Serum VEGF and SDF-l Levels Combined with Clinical Features in Predicting Short-term Prognosis of Moyamoya Disease Patients. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1650-1654.
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2021, Vol. 38 
