Correlation Between Collateral Circulation With VEGF,bFGF And Risk Factors In Ischemic Stroke Patients At Middle And High Altitude

Purpose: The levels of VEGF and bFGF in patients with ischemic stroke at medium and high altitude were measured by ELISA,the correlation between VEGF、bFGF and collateral circulation was explored to provide a theoretical basis for the serum prediction indicators and drug intervention of the establishment of collateral circulation in patients with ischemic stroke at medium and high altitude.Methods: A project study was carried out on 92 patients with first-time stroke,from 2019.01 to 2020.12,all of whom had the M1 segment of middle cerebral artery had obvious stenosis or occlusion.According to the DWI-ASPECTS score,they were divided into two groups: DWI-ASPECTS score greater than 7 and DWIASPECTS score less than or equal to 7.Cerebral infarction group were divided into 6groups(0,1,2,3,4,5)according to the multi-phase angiography(m CTA)collateral circulation score.46 physical examinees served as healthy control group.Baseline data(gender,age,ethnicity,etc.),blood biochemical data(routine blood test,blood biochemical test,blood coagulation test,etc.)and imaging data(DWI,CTA,m CTA)were collected.The levels of VEGF and bFGF were determined by ELISA.Results:1.The differences between the group with stroke in middle and high altitudearea and the healthy control group,in hypertension history,diabetes history and carotid plaque,NLR,PLR,LDL-C,HDL-C,Hcy,VEGF and bFGF levels,were statistica-lly higher(P <0.05);2.There were significant differences in VEGF,bFGF,NLR,LDLC and Hcy levels,between the group with good collateral circulation and the group with poor collateral circulation after ischemic stroke in the middle and high altitude area(P<0.05);3.Compared with the control group,the level of VEGF and bFGF were higher in good collateral circulation group,which is statistically different(P=0.000,P=0.000);The poor collateral circulation group’s VEGF was significantly higher than the health control group(P=0.000);the poor collateral circulation group’s bFGF was higher but the difference was not significant(P=0.095);4.The poor group’s the NIHSS and m RS score were statistically higher(P <0.05);5.Spearman indicated that is was related between the level of collateral circulation establishment and serum VEGF、bFGF levels in patients with ischemic stroke at middle and high altitude(P=0.001、P=0.006);6.Binary logistic analysis suggested that NLR is an independent adverse factor of poor collateral circulation after ischemic stroke in middle and high altitude area,and the higher the level of NLR,the greater the risk of poor collateral circulation;VEGF and bFGF are independent protective factors for collateral circulation establishment after stroke.With the increase of VEGF or bFGF,collateral circulation was better established;7.ROC curve shows that the area of VEGF and bFGF curve is0.698 and 0.695,respectively,which are greater than 0.5,both of them have good predictive significance for collateral circulation establishment,and the predictive value of VEGF is better than bFGF.Conclusions:1.Higher levels of VEGF and bFGF in patients with ischemic stroke at middle and high altitude;2.VEGF and bFGF in patients with ischemic stroke in middle and high altitude areas can protect the establishment of collateral circulation;3.Both VEGF and bFGF levels can better predict the good establishment of collateral circulation in patients with ischemic stroke in middle and high altitude areas...