关键词: 大脑中动脉M1段闭塞; 血小板衍生生长因子; 胰岛素样生长因子1; 侧支循环

Abstract: Objective To investigate the relationships between levels of serum platelet-derived growth factor (PDGF),insulin-like growth factor-1 (IGF-1) and collateral circulation formation with prognosis in patients with middle cerebral artery M1 segment occlusion (M1CAO).Methods The 158 patients with M1CAO admitted from February 2017 to August 2018 were selected as disease group,and 169 outpatient health examiners were selected as the control group.All patients with M1CAO were diagnosed by magnetic resonance angiography(MRA) one week after onset.According to the formation of collateral circulation compensation,the patients were divided into the non-compensated group,the isolated anterior cerebral artery(ACA) compensated group,the isolated posterior cerebral artery(PCA) compensated group and the ACA+PCA compensated group.The levels of serum PDGF and IGF-1 were detected by enzyme linked immunosorbent assay(ELISA).The neurological deficits of M1CAO patients were scored by National institutes of health stroke scale（NIHSS） on the day of hospitalization and 15 days after hospitalization.The modified Rankin scale(mRS) was used to evaluate the prognosis of M1CAO patients 90 days after discharge,and the patients were divided into good prognosis group and poor prognosis group according to the mRS score.The clinical data of each group were compared.Pearson correlation analysis was used to analyze the correlation between serum PDGF and IGF-1 levels.Logistic regression analysis was used to analyze the factors affecting the prognosis of patients with M1CAO.Results Compared with the control group,the levels of serum PDGF and IGF-1 of the disease group were significantly lower(P<0.05).Compared with the non-compensated group,the levels of serum PDGF and IGF-1 in patients with M1CAO in isolated ACA compensated group,isolated PCA compensated group and ACA+PCA compensated group increased significantly,while the NIHSS score decreased successively(P<0.05).Compared with the poor prognosis group,the levels of serum PDGF and IGF-1 in good prognosis group were significantly higher(P<0.05).Pearson correlation analysis showed that serum PDGF and IGF-1 levels were positively correlated in M1CAO patients(r=0.414,P<0.05).Logistic regression analysis showed that high levels of serum PDGF and IGF-1 and collateral circulation were independent protective factors of the good prognosis in M1CAO patients(P<0.05).Diabetes mellitus was an independent risk factor of the poor prognosis in M1CAO patients(P<0.05).Conclusion The levels of serum PDGF and IGF-1 in M1CAO patients are significantly decreased,and the increase of PDGF and IGF-1 levels is related to the formation of collateral circulation and good prognosis,and is an independent affective factor for the prognosis of M1CAO patients.

Key words: Middle cerebral artery M1 occlusion; Platelet-derived growth factor; Insulin-like growth factor-1; Collateral circulation