Setyopranoto Ismail, Sadewa Ahmad Hamim, Wibowo Samekto, Widyadharma I Putu Eka
Department of Neurology, Faculty of Medicine, Universitas Gadjah Mada and Dr Sardjito General Hospital, Yogyakarta, Indonesia.
Department of Biochemistry, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Open Access Maced J Med Sci. 2019 Mar 13;7(5):747-751. doi: 10.3889/oamjms.2019.175. eCollection 2019 Mar 15.
Glucose and oxygen supply to neurons are disrupted during acute ischemic stroke, resulting in hypoxia. This event, in turn, activates the transcription of hypoxia-inducible factor (HIF-1), which is responsible for activating genes responsible for angiogenesis, including vascular endothelial growth factor (VEGF). VEGF and their receptor systems exert complex mechanisms of angiogenesis, including the stimulator, inhibitors, angiogenic and modulator. VEGF-A is the primary regulator of angiogenesis, both during physiological and pathological conditions. Nevertheless, the role of VEGF on the prognosis of hypoxia remains controversial.
The purpose of this study was to address if there is any difference between the mean expression of VEGF-A between acute ischemic patients and non-ischemic stroke subjects.
This was an observational study with a cross-sectional design, the population in this research is the acute ischemic stroke patients and non-ischemic stroke subjects, which were admitted on Emergency Room and later treated in the Stroke Unit, Dr Sardjito General Hospital, Yogyakarta, Indonesia. Subjects were recruited using the purposive method, yielding a total of 64 subjects on both groups. Diagnosis of acute ischemic stroke was established using a head CT scan. Patients who meet the inclusion criteria and willing to participate in the study were asked to provide informed consent. Laboratory analysis was conducted during the first 24 hours after being treated at Stroke Unit, Dr Sardjito General Hospital, Yogyakarta, Indonesia, with venous blood was withdrawn VEGF-A levels between acute ischemic stroke and non-ischemic stroke subjects were subsequently compared. Categorical variables (including gender) were tested using either chi-square or Fisher exact test. Interval data was examined using student t-test if data distribution was normal.
As many as 35 acute ischemic stroke and 35 non-ischemic stroke patients were included in the study, among whom were 18 men (51.43%) and 17 women (48.57%) among stroke patients and 21 (60%) men and 14 (40%) women among subjects without stroke. The average of the subject's age on stroke and non-ischemic stroke group was 58.51 and 48.57 years old. VEGF-A levels were significantly higher in the non-stroke group (561.77 ± 377.92) compared with stroke group (397.78 ± 181.53) with p = 0.02.
expression of VEGF-A in acute ischemic stroke group was lower when compared with the non-stroke group.
急性缺血性卒中期间，神经元的葡萄糖和氧气供应中断，导致缺氧。这一事件进而激活缺氧诱导因子（HIF-1）的转录，HIF-1负责激活包括血管内皮生长因子（VEGF）在内的与血管生成相关的基因。VEGF及其受体系统发挥着复杂的血管生成机制，包括刺激因子、抑制剂、血管生成因子和调节剂。VEGF-A是生理和病理条件下血管生成的主要调节因子。然而，VEGF对缺氧预后的作用仍存在争议。
本研究的目的是探讨急性缺血性患者与非缺血性卒中受试者之间VEGF-A的平均表达是否存在差异。
这是一项采用横断面设计的观察性研究，本研究的人群为急性缺血性卒中患者和非缺血性卒中受试者，他们在印度尼西亚日惹市萨迪托综合医院急诊科就诊，随后在卒中单元接受治疗。采用目的抽样法招募受试者，两组共招募64名受试者。采用头颅CT扫描确诊急性缺血性卒中。符合纳入标准且愿意参与研究的患者被要求提供知情同意书。在印度尼西亚日惹市萨迪托综合医院卒中单元接受治疗后的头24小时内进行实验室分析，采集静脉血，随后比较急性缺血性卒中与非缺血性卒中受试者的VEGF-A水平。分类变量（包括性别）使用卡方检验或Fisher精确检验进行检验。如果数据分布正常，区间数据使用学生t检验进行检验。
本研究共纳入35例急性缺血性卒中和35例非缺血性卒中患者，其中卒中患者中有18名男性（51.43%）和17名女性（48.57%），非卒中受试者中有21名男性（60%）和14名女性（40%）。卒中组和非缺血性卒中组受试者的平均年龄分别为58.51岁和48.57岁。非卒中组的VEGF-A水平（561.77±377.9）显著高于卒中组（397.78±181.53），p = 0.02。
与非卒中组相比，急性缺血性卒中组中VEGF-A的表达较低。
