Correlation Study Among Serum CPP、VEGF And Acute Cerebral Infarction

Objective:This study was to investigate the circulating levels of copeptin(CPP) and vascular endothelial growth factor(VEGF) and the diagnosis, the prognostic use for the severity and the correlation of both biomarkers in patients with acute cerebral infarction(ACI).Methods:1.Serum copeptin(CPP)and vascular endothelial growth(VEGF) levels were measured with Enzyme-linked Immunosorbent assay(ELISA) in seventy consecutive patients with ACI and healthy controls.2.The neurological functional impairment was assessmented by National Institutes of Health Stroke Scale( NIHSS).3.The infarction location and volume were measured with magnetic resonance imaging(MRI) inspection.4. Carotid artery atherosclerosis was evaluated by Color Doppler Ultrasound(CDU).5. Statistical methods were used to analyse the correlations among copeptin levels,nerve functional outcome,infarction volume and carotid artery atherosclerosis lesions combined with VEGF levels.Results:1.The incidences of smoking,drinking,family history,hypertension,hyperlipidemia,diabetes mellitus, cerebral artery stenosis and intracranial artery stenosis were higher in ACI group than those in control group(P<0.05).2.CPP、VEGF levels in peripheral blood were significantly higher in patients with acute cerebral infarction compared to controls(P<0.05); CPP and VEGF levels correlated positively with the severity of ACI measured by NIHSS(r=0.846 and 0.752,P<0.001);CPP levels were significantly associated with VEGF levels and C-reactive protein respectively(r=0.886 and 0.868,P<0.001).3.For the prediction of ACI, the cut-off values of CPP and VEGF were 8.40pmol/L、526.48pg/ml respectively.The sensitivity were 56.2% and 72.9% respectively.The specificity were respectively 88.9% and 70.4%. Receiver operating characteristics analysis revealed an area under the curve(AUC) was 0.857( 95%CI:0.785~0.929) for CPP,0.855( 95%CI: 0.784~0.926) for VEGF(P>0.05).4. Serum CPP、VEGF levels varied with infarction lesion size.The large lesion group had higher CPP levels and VEGF levels than other lesion group(P<0.05). CPP levels were positively correlated with infarction lesion size(r=0.654,P<0.001),so were VEGF levels(r=0.563, P <0.001).5. Serum CPP、VEGF levels were higher in carotid artery lesion group than that in the normal group. The median CPP level and VEGF level were 13.01 pmol/L(IQR:10.45-15.50) and 861.00 pg/ml(IQR:703.01-961.70) in carotid artery atherosclerosis group with the highest levels(P<0.05).6. Multiple stepwise regression analysis shows: VEGF levels, CRP levels, N% and age had a great influence on CPP concentration; CPP levels, N% and HCT also affected VEGF concentration.Conclusion:1.CPP and VEGF levels were closely related to severity and infarction lesion volume in patients with ACI;They can be used as good biomarkers for the clinical early diagnosis and prognosis of ACI.2.CPP had a positive correlation with VEGF, thus, the two mechanisms may have synergistic effect.3.ACI patients had more chance to have carotid artery atherosclerosis,which indicated CPP、VEGF may play a role in the pathogenesis of atherosclerosis lesion.