Abstract：
Enhancement of vascular remodeling in affected brain tissue is a novel therapy for acute ischemic stroke (AIS). However, conclusions regarding angiogenesis after AIS remain ambiguous. Vascular endothelial growth factor A (VEGFA) and VEGF receptor 2 (VEGFR2) are potent regulators of angiogenesis and vascular permeability. We aimed to investigate the association between VEGFA/VEGFR2 expression in the acute stage of stroke and prognosis of patients with AIS. We enrolled 120 patients with AIS within 24 h of stroke onset and 26 healthy controls. Plasma levels of VEGFA and VEGFR2 were measured by enzyme-linked immunosorbent assay (ELISA). The primary endpoint was an unfavorable outcome defined as a modified Rankin Scale (mRS) score > 2 at 3 months after AIS. Univariate and multivariate logistic regression analyses were used to identify risk factors affecting prognosis. Plasma VEGFA and VEGFR2 were significantly higher in patients with AIS than in health controls, and also significantly higher in patients with unfavorable than those with favorable outcomes. Moreover, both VEGFA and VEGFR2 showed a significantly positive correlation with mRS at 3 months. Univariate and multivariate analyses showed VEGFA and VEGFR2 remained associated with unfavorable outcomes, and adding VEGFA and VEGFR2 to the clinical model significantly improved risk reclassification (continuous net reclassification improvement, 105.71%; integrated discrimination improvement, 23.45%). The new risk model curve exhibited a good fit with an area under the receiver operating characteristic curve (ROC) curve of 0.9166 (0.8658-0.9674). Plasma VEGFA and VEGFR2 are potential markers for predicting prognosis; thus these two plasma biomarkers may improve risk stratification in patients with AIS.
摘要：
在受影响的脑组织中增强血管重塑是急性缺血性中风（AIS）的一种新颖疗法。然而,关于AIS后血管生成的结论仍然不明确.血管内皮生长因子A（VEGFA）和VEGF受体2（VEGFR2）是血管生成和血管通透性的有效调节剂。我们旨在研究VEGFA/VEGFR2在卒中急性期的表达与AIS患者预后的关系。我们招募了120例中风发作24小时内的AIS患者和26例健康对照。采用酶联免疫吸附试验(ELISA)检测VEGFA和VEGFR2的血浆水平。主要终点是不良结局，定义为AIS后3个月的改良Rankin量表（mRS）评分>2。采用单因素和多因素logistic回归分析确定影响预后的危险因素。AIS患者的血浆VEGFA和VEGFR2显著高于健康对照组,并且在预后不良的患者中也显着高于预后良好的患者。此外，VEGFA和VEGFR2在3个月时与mRS呈显著正相关。单变量和多变量分析显示，VEGFA和VEGFR2仍然与不良结局相关，并在临床模型中加入VEGFA和VEGFR2显著改善了风险重分类（持续净重分类改善，105.71%；综合歧视改善，23.45%）。新的风险模型曲线表现出与0.9166（0.8658-0.9674）的受试者工作特征曲线（ROC）曲线下面积的良好拟合。血浆VEGFA和VEGFR2是预测预后的潜在标志物;因此这两种血浆生物标志物可以改善AIS患者的风险分层。
