血管内皮细胞生长因子与冠状动脉狭窄及侧支循环的关系

Relationship between vascular endothelial growth factor and the degree of coronary artery stenosis and the formation of collateral circulation

【摘要】目的探讨急性心肌梗死患者血浆中血管内皮细胞生长因子的含量与冠状动脉狭窄程度及侧支循环形成的关系。方法对76例急性心肌梗死患者于入院后3—7天及6个月分别进行冠状动脉造影检查，确定冠状动脉狭窄的程度及有无侧支循环形成；于首次冠状动脉造影检查时采血5mL，采用酶联免疫吸附法检测血浆中血管内皮细胞生长因子含量。结果冠状动脉狭窄程度〈50％、50％一75％和〉75％的患者血浆血管内皮细胞生长因子含量分别为97．6±17，3ng／L、241．6±28．9ng／L和391．7±48．4ng／L，不同冠状动脉狭窄程度的血浆血管内皮细胞生长因子含量比较差异有统计学意义（P〈0．01）；24例有侧支循环形成的患者与52例无侧支循环形成的患者血浆中血管内皮细胞生长因子含量分别为410．3±42．9ng／L和：220，9±105．2ng／L，两组比较差异有统计学意义（P〈0．01）。结论急性心肌梗死患者血浆中血管内皮细胞生长因子的含量愈高，冠状动脉狭窄程度愈重，愈有利于侧支循环的形成。

Objective To study the relation between vascular endothelial growth factor（VEGF） and the degree of coronary artery stenosis as well as the formation of collateral circulation in patients with acute myocardial infarction （AMI）. Methods Seventy-six cases of AMI had undertaken selective coronary angiography on the third to seventh day after admission and also at six months afterwards in order to define the degree of coronary artery stenosis and the presence of collateral circulation. A blood sample of 5 mL was taken in each patient before the first coronary angiography to test for the level of VEGF by enzyme linked immunosorbend assay, Results The level of VEGF in patients with coronary artery stenosis less than 50%, 50% -75% and greater than 75% were （97.6 ± 17.3） ng/L, （241.6±28.9） ng/L and （391.7±48.4） ng/L respectively （P 〈0.01 ）. Formation of collateral circulation was found in 24 cases but was absent in the other 52 cases in the follow-up angiography after 6 months and the respective level of VEGF in each group were （410. 3±42.9） ng/L and （220.9±105.2） ng/L （P〈0.01）. Conclusion The plasma level of VEGF increases along with the severity of coronary artery stenosis and is also related to the formation of collateral circulation after acute myocardial infarction.