The Predictive Value of Serum VEGF-C and HPSE for the Short Term Prognosis of Patients with Hypertensive Intracerebral Hemorrhage Treated with Small Bone Window Surgery

ZHAO Fugang; GUAN Peng; TIAN Mi; FANG Yilin; NIU Sen

doi:10.3639/j.issn.2095-3097.2025.07.005

Abstract：Objective To analyze the predictive value of serum vascular endothelial growth factor C(VEGF-C)and heparanase(HPSE)for short-term poor prognosis in patients with hypertensive intracerebral hemorrhage(HICH)treated with small bone window surgery.Methods A total of 215 patients with HICH who underwent small bone window surgery at Hefei Eighth People's Hospital from June 2020 to June 2024 were retrospectively selected.According to the modified Rankin scale score at 90 days after surgery,the patients were divided into a good prognosis group(154 cases)and a poor prognosis group(61 casese).The general clinical data,serum VEGF-C levels,and HPSE levels in the two groups were compared.Multivariate Logistic stepwise regression analysis was used to analyze influencing factors of short-term poor prognosis in HICH patients treated with small bone window surgery.The receiver operating characteristic(ROC)curve was constructed,and the predictive value of VEGF-C and HPSE for short-term poor prognosis in HICH patients after small bone window surgery was evaluated by area under the curve(AUC).Results The age,duration of hypertension,National Institutes of Health stroke scale score on admission,proportion of irregular hematoma shape,hematoma volume,and D-dimer level in the poor-prognosis group were significantly higher than those in the good-prognosis group,while the Glasgow coma score was significantly lower(P<0.05).The levels of serum VEGF-C and HPSE in the poor prognosis group were significantly higher than those in the good prognosis group[(89.61±6.14)ng/L vs(81.25±6.02)ng/L,P<0.001;(4.82±1.03)ng/mL vs(3.42±0.62)ng/mL,P<0.001].Multivariate Lo-gistic stepwise regression analysis showed that increased National Institutes of Health stroke scale score at admission,increased hematoma volume,increased D-dimer,increased VEGF-C,and increased HPSE were independent risk factors for short-term poor prognosis in HICH patients treated with small bone window surgery(OR=2.776,95%CI:1.437-5.363,P=0.002;OR=2.208,95%CI:1.258-3.875,P=0.006;OR=2.282,95%CI:1.491-3.491,P<0.001;OR=1.912,95%CI:1.282-2.851,P=0.001;OR=2.069,95%CI:1.295-3.305,P=0.002).The AUC for predicting short-term poor prognosis in HICH patients undergoing small bone window surgery using the combination of VEGF-C and HPSE was 0.901,which was significantly higher than the AUCs for VEGF-C alone(0.785)and HPSE alone(0.864)(Z=10.394,9.577,P<0.001).Conclusion Elevated levels of serum VEGF-C and HPSE are closely related to short-term poor prognosis in HICH patients treated with small bone window surgery.The predictive value of combined prediction is significantly better than that of single prediction,and they can be used as biomarkers for short-term prognosis assessment.