| Objectives:To explore the relationship between the serum BDNF、VEGF、MMP-9concentration and vascular dementia and the predicting value of the serum BDNF、VEGF、 MMP-9concentration on vascular dementia in patients with cerebral infarction, to evaluate the the role of some potential risk factors for vascular dementia in these patients.Methods:The first-ever acute cerebral infarction patients were collected in stroke unit ward of the Tianjin Huanhu Hospital during April1,2013to October31,2013. Healthy volunteers were recruited as the healthy control. Clinical information of the object were comprehensive collected, fasting blood specimens were collected on the early morning. The concentrations of serum BDNF, VEGF, MMP-9were quantitatively determinated by ELISA, cerebral infarction group and healthy control group were completed HAMD、HAMA、NIHSS、HIS、MMSE、MoCA score when they into the test and after3months. According to MMSE score results of patients with cerebral infarction after3month, cerebral infarction patients were divided into VaD group and non vascular dementia (N-VaD) group. First, compared respectively of the differences of serum BDNF、VEGF、MMP-9concentration between the cerebral infarction group and healthy control group, to understand the change direction of the three observation indexes in serum when people set cerebral infarction.Then, compared respectively of the differences of serum BDNF、VEGF、MMP-9concentration between the VaD group and N-VaD group, and to explore the predictive value of VaD group after cerebral infarction of serum BDNF, VEGF, MMP-9concentration. The impact of major risk factors for VaD in patients with cerebral infarction was analyzed by logistic regression model.Results:1. There are no statistical differences in baseline information between238cases of cerebral infarction patients and100cases of healthy control group (P>0.05).2. Compared with healthy control group, the cerebral infarction patients had significantly higher BDNF concentration ([6.23±2.03] ng/ml vs [4.20±2.18] ng/ml; P＜0.001), higher VEGF concentration ([248.69±24.16] pg/ml vs [199.97±16.50] pg/ml; P＜0.001), and higher MMP-9concentration ([250.70±47.08] ng/ml vs [178.07±20.04] ng/ml; P＜0.001).3. There are52VaD after cerebral infarction and186N-VaD after cerebral infarction,44cases of VaD group have hypertension (84.62%) is significantly higher than the N-VaD group of120cases (64.52%)(P=0.006); VaD group of38patients with diabetes mellitus (73.08%) were significantly higher than the N-VaD group of90patients (48.39%)(P=0.002).Between the two groups of age, gender, education, smoking, drinking and other baseline data there was no statistically significant difference (P>0.05).4. VaD group serum BDNF and VEGF concentration (4.50±1.90ng/ml,227.35±19.33pg/ml) were significantly lower than the N-VaD group (6.72±1.79ng/ml,254.65±21.93pg/ml), the difference between the two groups was statistically significant (P<0.001); VaD group serum concentrations of MMP-9(292.92±49.90ng/ml) was significantly higher than that of N-VaD group (238.90±38.89ng/ml), differences between the two groups was statistically significant(P<0.001.).5. Multivariate analysis results showed that:lower serum BDNF concentration (OR=0.529, P＜0.001), lower serum VEGF concentration (OR=0.970, P=0.008), higher serum MMP-9concentration (OR=1.019, P<0.001), hypertension (OR=10.962, P＜0.001), diabetes mellitus (OR=4.871, P=0.004) were independent risk factors of VaD in patients with cerebral infarction.6. The concentration of BDNF<6.18ng/ml or VEGF<238.99pg/ml or MMP-9≥258.15ng/ml can predict the occurrence of VaD in patients with cerebral infarction they respectively accuracy rate was71.01%、84.45%、79.83%; Combination of BDNF and VEGF to predict the accuracy of VaD in patients with cerebral infarction,the accuracy rate was88.24%; Combination of BDNF and MMP-9to predict the accuracy of VaD in patients with cerebral infarction,the accuracy rate was88.66%; Combination of VEGF and MMP-9to predict the accuracy of VaD in patients with cerebral infarction,the accuracy rate was86.97%; Combination of the three biomarkers to predict the accuracy of VaD after cerebral infarction, the accuracy rate was92.02%.Conclusions:1. The serum BDNF、VEGF and MMP-9concentration of the cerebral infarction patients are higher than the healthy control group.2. Hypertension diabetes mellitus、lower serum BDNF concentration、lower serum VEGF concentration and higher serum MMP-9concentration was independent risk factors for VaD in patients with cerebral infarction.3. Serum concentration of BDNF≤6.18ng/ml or serum concentration of VEGF≤238.99pg/ml or serum concentration of MMP-9≥258.15ng/ml was predictive factors for VaD in patients with cerebral infarction incidence.4. The pretective value of the three biomarkers is prior to the single or two of the three. |
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