血管内皮生长因子与急性呼吸窘迫综合征关系的研究

Relationship between vascular endothelial growth factor and acute respiratory distress syndrome

目的探讨血管内皮生长因子(VEGF)在急性呼吸窘迫综合征(ARDS)肺毛细血管通透性改变中的作用。方法测定30例ARDS患者、18例具有发生ARDS高危因素但未发生ARDS的患者、12例单纯机械通气患者以及11例正常对照者血浆VEGF、IL-6、sVEGFR-1、sVEGFR-2水平。结果ARDS患者血浆VEGF水平与未发生ARDS高危因素组和单纯机械通气组比较明显升高[(181.25±57.60)pg/mLvs(122.03±54.02)pg/mL和(82.33±36.38)pg/mL,P均<0.001];ARDS患者存活组VEGF水平与死亡组比较差异无统计学意义(P>0.05)。ARDS组血浆sVEGFR-1水平分别与未发生ARDS的高危因素组、单纯机械通气组及正常对照组比较差异无统计学意义(P>0.05),sVEGFR-2水平有低于正常对照组趋势,但无统计学意义。ARDS患者血浆IL-6水平较未发生ARDS的高危因素患者明显升高(P<0.001),且与IL-6水平呈正相关(r's=0.587,P<0.001)。结论升高的VEGF可能在ARDS早期发生中发挥了作用,IL-6可能参与此调节机制中。

Objective To discuss the effect of vascular endothelial growth factor（ VEGF ） on the changes of pulmonary capillary permeability in the patients with acute respiratory distress syndrome （ ARDS ）. Methods Plasma VEGF, sVEGFR - 1, sVEGFR - 2 and IL - 6 were measured with ELISA in 30 patients with ARDS, 18 high risk patients, 11 normal controls, and 12 ventilated control subjects. Resuits Compared with high risk patients and ventilated control subjects, plasma VEGF in the patients with ARDS was higher （ P 〈 0. 001）. There were no statistical significances in VEGF between the survivals and the dead （P 〉 0.05 ）. Compared with the three other groups, there was also no statistical significance in the plasma sVEGFR - 1 of patients with ARDS （ P 〉 0.05 ）, but sVEGFR - 2 in patients with ARDS tended to be lower in comparison with control group. Compared with high risk patients, plasma IL -6 in the patients with ARDS was elevated, which correlated positively with VEGF （r＇s = 0. 587, P 〈 0. 001 ）. Condusions Elevated VEGF levels would play a role in the development of ARDS.