实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (1): 32-36.doi: 10.3969/j.issn.1003-9198.2025.01.008

• 临床研究 • 上一篇    下一篇

老年血管性痴呆病人血清VEGF、BDNF水平与病情严重程度的关系及对预后的预测价值

王雪, 张振勇, 许彬, 朱娅, 周璇, 张永嘉, 庄瑞娟   

  1. 214000 江苏省无锡市,江南大学附属医院老年医学科(王雪,张振勇,许彬,朱娅,周璇,庄瑞娟);
    225000 江苏省扬州市,扬州大学附属医院心血管内科(张永嘉)
  • 收稿日期:2024-01-11 出版日期:2025-01-20 发布日期:2025-01-15
  • 通讯作者: 庄瑞娟,Email:rjzhuang@126.com
  • 基金资助:
    江苏省科技项目(BK20211011)

Study on association of serum levels of VEGF and BDNF with severity of vascular dementia and predictive value for prognosis

WANG Xue, ZHANG Zhenyong, XU Bin, ZHU Ya, ZHOU Xuan, ZHANG Yongjia, ZHUANG Ruijuan   

  1. Department of Geriatrics, Affiliated Hospital of Jiangnan University, Wuxi 214000, China(WANG Xue, ZHANG Zhenyong, XU Bin, ZHU Ya, ZHOU Xuan, ZHUANG Ruijuan);
    Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou 225000, China(ZHANG Yongjia)
  • Received:2024-01-11 Online:2025-01-20 Published:2025-01-15
  • Contact: ZHUANG Ruijuan,Email:rjzhuang@126.com

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摘要： 目的 探究老年血管性痴呆(VD)病人血清血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)水平与病情严重程度的关系及对预后的预测价值。方法 回顾性分析江南大学附属医院2022—2023年收治的102例VD病人,根据病人病情严重程度将其分为轻度(37例)、中度(43例)、重度(22例)3组。抽取病人入院后24 h内空腹静脉血,用酶联免疫吸附法测定BDNF、VEGF水平,分析BDNF、VEGF水平与病人病情严重程度的关系。出院后对病人进行为期3个月的随访,根据病人预后情况将其分为预后良好组(77例)与预后不良组(25例),分析病人预后的影响因素,采用ROC曲线分析BDNF、VEGF对病人预后的预测价值。结果 重度VD病人VEGF、BDNF水平低于中度、轻度病人,中度VD病人VEGF、BDNF水平低于轻度病人(P＜0.05)。VD病人MMSE评分与VEGF、BDNF水平均呈显著负相关(P＜0.05)。单因素分析结果显示,预后不良组年龄、吸烟史比例、病情严重程度为重度比例均高于预后良好组,VEGF、BDNF水平低于预后良好组(P＜0.05)。二元Logistic回归分析结果显示,年龄、病情严重程度是病人预后的独立危险因素,VEGF、BDNF是独立保护因素(P＜0.05)。ROC曲线结果显示,VEGF、BDNF及二者联合预测病人预后的敏感度分别为76.20%、72.00%、92.10%,特异度分别为75.30%、72.70%、90.90%,AUC分别为0.831、0.805、0.938。结论 老年VD病人病情严重程度与VEGF、BDNF水平呈显著负相关;临床通过联合检测BDNF、VEGF水平可有效预测病人预后情况。

关键词: 老年人, 血管性痴呆, 血管内皮生长因子, 脑源性神经营养因子, 预后预测

Abstract: Objective To explore the relationship of the levels of serum vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF) with the severity of vascular dementia (VD) in the elderly patients, and to investigate the predictive value of VEGF and BDNF for prognosis. Methods A retrospective analysis was performed on the clinical data of 102 elderly patients with VD admitted to Affiliated Hospital of Jiangnan University from January 2022 to December 2023. The patients were divided into mild group (37 cases), moderate group (43 cases) and severe group(22 cases) according to the severity of the VD.Fasting venous blood samples were collected within 24 h after admission. The levels of BDNF and VEGF were determined by enzyme-linked immunosorbent assay, and the relationship between BDNF, VEGF and the severity of VD was analyzed. The patients were followed up for 3 months after discharge, and were divided into good prognosis group (77 cases) and poor prognosis group (25 cases) according to the prognosis. The influencing factors of prognosis were analyzed. The predictive value of BDNF and VEGF for the prognosis of patients was analyzed by receiver operating characteristic (ROC) curve. Results The levels of VEGF and BDNF were lowest in severe group, followed by moderate group and mild group (P<0.05). The score of Mini-mental State Examination (MMSE) was negatively correlated with the levels of VEGF and BDNF (P<0.05). Univariate analysis showed significant differences in age, proportion of smoking history and severe disease severity, and the levels of VEGF and BDNF between the good prognosis group and the poor prognosis group (P<0.05). Binary Logistic regression analysis showed that age and disease severity were independent risk factors for the prognosis of patients, and VEGF and BDNF were independent protective factors (P<0.05). The results of ROC curve showed that the sensitivity of VEGF, BDNF and their combination to predict the prognosis of patients was 76.20%, 72.00%, 92.10%, respectively, the specificity was 75.30%, 72.70%, 90.90%, respectively, and the area under the curve (AUC) was 0.831, 0.805 and 0.938, respectively (P<0.05). Conclusions The severity of VD is significantly negatively correlated with the levels of VEGF and BDNF. The combined detection of BDNF and VEGF levels can effectively predict the prognosis of VD patients.

Key words: aged, vascular dementia, vascular endothelial growth factor, brain-derived neurotrophic factor, prognostic prediction

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