急性肺损伤患者肺泡灌洗液及血清中角细胞生长因子和肝细胞生长因子水平变化的意义

Changes of Keratinocyte and Hepatocyte Growth Factor Contents in Bronchoalveolar Lavage Fluid and Serum in Patients with Acute Lung Injury

目的探讨急性肺损伤(ALI)患者支气管肺泡灌洗液(BALF)及血清中肝细胞生长因子(HGF)和角细胞生长因子(KGF)水平变化的临床意义。方法选择30例ALI患者,其中轻中度损伤16例(A组),重度损伤14例(B组),另选择健康非吸烟的自愿献血者10名作为血清对照组(C组),10名BALF检查无异常的就诊者作为BALF对照组(D组),用ELISA法检测30例ALI患者血清及BALF中HGF和KGF的水平。结果A、B、D3组患者的BALF及血清中HGF、KGF水平比较差异均有统计学意义(P<0.05),B组患者BALF中KGF、HGF水平与A组比较差异有统计学意义(P<0.05)。死亡组患者BALF中HGF和KGF水平与存活组比较差异有统计学意义(P<0.05),死亡组患者血清中HGF和KGF水平与存活组比较差异亦有统计学意义(P<0.01)。BALF中HGF和KGF水平与肺损伤系数呈正相关(P<0.01)。结论多种炎症细胞及递质参与ALI的病理过程,HGF和KGF在ALI的发生、发展中起重要的作用。BALF及血清中HGF和KGF可作为ALI病情监测和预后判定的参考指标。

Objective TO detect levels of keratinocyte growth factor （KGF） and hepatocyte growth factor （HGF） in bronchoalyeolar lavage fluid （BALF） and serum in patients with acute lung injury （ ALl ） , and to investigate clinical significance of growth factors in pathogenesis of ALI Methods Thirty ALI patients were divided into 2 groups： Group A （with moderate lung injury, n = 16） and Group B （with severe lung injury, n = 14） , and 10 healthy unsmoking voluntary blood donors were enrolled as Group C （ serum control group）. ELISA was used to detect the levels of HGF and KGF in BALF and serum. Results HGF and KGF were significantly higher in BALF than in serum, and HGF and KGF in serum were significantly higher in Group B than in Group A. Group A was significantly different from Group B in levels of KGF and HGF in BALF. In both BALF and serum, levels of HGF and KGF of Group A and Group B were higher than those of Group C. Conclusion A variety of inflammatory cells and neurotransmitters are involved in the pathological process of ALI; HGF and KGF play an important role in occurrence and development of ALI. BALF as well as HGF and KGF can be used as a reference index of pathogenetic condition monitoring and prognosis determination of ALI.