ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 12 of 39
УЖМБС 2021, 6(2): 87–93
Clinical Medicine

Prognostic Value of Serum Concentration of Vascular Endothelial Growth Factor A in Patients in Acute Period of Spontaneous Supratentorial Intracerebral Hemorrhage

Kuznietsov A. A.

The aim of the study – to evaluate the informativeness of serum vascular endothelial growth factor A levels in detection of short-term prognosis in acute period of spontaneous supratentorial intracerebral hemorrhage on the ground of conservative treatment. Materials and methods. Prospective cohort comparative study of the 89 patients in acute period of spontaneous supratentorial intracerebral hemorrhage was done on the ground of conservative treatment. The evaluation of neurological deficit level was performed by using Full Outline of Unresponsiveness coma scale, Glasgow scale and National Institute of Health Stroke Scale. Cerebral brain structures visualization was made by computed tomography. During 24 hours of hospitalization serum samples were collected and vascular endothelial growth factor A (VEGF-A) was measures by using ELISA method. Early neurological deterioration and unfavorable acute spontaneous supratentorial intracerebral hemorrhage period outcome (4-6 score by modified Rankin scale on the 21st day of the disease) were registered as combined clinical endpoints. Statistical operation was made with the help of correlation analysis, logistic regression analysis, ROC-analysis. Results. Patients with unfavorable course and spontaneous supratentorial intracerebral hemorrhage acute period outcome were characterized by higher serum VEGF-A values on the 1st day from admission, that correlates with the volume of intracerebral hemorrhage (R=0,21, p˂0,01), volume of secondary intraventricular hemorrhage (R=0,29, p˂0,01) and total volume of intracranial hemorrhage (R=0,31, p˂0,01). It was detected that evaluation of VEGF-A serum concentrations together with neurovisualization parameters (midline shift severity, volume of secondary intraventricular hemorrhage) as a part of multipredictive logistic regression model allow to detect individual risk of early neurological deterioration with the accuracy 89,9% (AUC±SE (95% CI) = 0,91±0,04 (0,83-0,96), р˂0,0001). Conclusions. Serum VEGF-A levels in patients with spontaneous supratentorial intracerebral hemorrhage on the 1st day from admission is an informative additional parameter for prognosis of early neurological deterioration on the ground of conservative treatment

Keywords: intracerebral hemorrhage, vascular endothelial growth factor, functional prognosis

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