目的：探讨急性脑梗死患者外周血中低氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）、Bcl-2水 平的动态变化规律及与早期神经功能恶化（END）的相关性。方法：脑梗死患者173例根据美国国立卫生研 究院卒中量表（NIHSS）评分，分为 END 组 59 例和非 END 组 114 例。采用 ELISA 法检测 2 组患者入院后 12 h、24 h、3 d、5 d、7 d、10 d外周血HIF-1α、VEGF、Bcl-2水平变化及与END发生的相关性。结果：END组 NIHSS评分及DWI-ASPECTS≤7分的患者比例明显高于非END组（P＜0.05）。脑梗死患者在入院24 h时 外周血HIF-1α、VEGF和Bcl-2水平达到高峰，且END组患者外周血HIF-1α、VEGF和Bcl-2水平均明显高于 非 END 组（P＜0.05）。END 程度越严重，患者外周血 HIF-1α、VEGF 和 Bcl-2 水平越高（P＜0.05）。多因素 Logistic回归分析显示，脑梗死患者END的发生风险与HIF-1α、VEGF和Bcl-2水平呈正相关性（P＜0.05）。 结论：外周血HIF-1α、VEGF和Bcl-2水平可能可作为急性脑梗死后神经功能损伤度的预测指标。

To study the dynamic changes in peripheral blood levels of hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), and Bcl-2 in patients with acute ischemic stroke (AIS) and its correlation to early neurological deterioration (END). Methods: We included 173 AIS patients in our study. Patients were divided into the END group (n=59) and non-END group (n=114) according to the NIHSS scores. The serum levels of HIF-1α, VEGF, and Bcl-2 in the peripheral blood of all patients were detected by ELISA at 12 h, 24 h, 3 d, 5 d, 7 d, and 10 d after hospitalization, and the relationship with END was evaluated. Results: The ratio of patients with NIHSS and DWI-ASPECTS scores ≤7 was higher in the END group than those in the non-END group (P<0.05). The serum levels of HIF-1α, VEGF, and Bcl-2 in AIS patients peaked at 24 h after hospitalization. Furthermore, the serum levels of HIF-1α, VEGF, and Bcl-2 in END patients were higher than those in non-END patients (P<0.05). Patients with more severe END showed higher serum levels of HIF-1 α, VEGF, and Bcl-2 (P<0.05). Multivariate logistic regression analysis showed that the incidence of END was positively correlated with HIF-1α, VEGF, and Bcl-2 (P<0.05). Conclusion: Peripheral blood levels of HIF-1α, VEGF, and Bcl-2 may serve as predictors of the degree of neurological deterioration after AIS.