血管内皮生长因子在肝硬化门静脉高压性胃病胃黏膜血管病变中的作用

Role of Vascular Endothelial Growth Factor in Gastric Mucosal Vascular Lesions in Patients with Liver Cirrhosis Portal Hypertensive Gastropathy

目的探讨血管内皮生长因子(VEGF)在肝硬化门静脉高压性胃病(PHG)患者胃黏膜血管病变中的作用。方法采用免疫组化法检测48例肝硬化门静脉高压症患者和18例正常对照者VEGF和CD34在胃黏膜组织中的表达,并对CD34阳性血管进行微血管密度(MVD)计数。结果48例患者经胃镜检查无PHG者13例,轻度PHG22例,重度PHG13例。PHG组、无PHG组及正常对照组VEGF积分光密度值〔(5.04±1.56)、(4.29±1.30)和(3.64±1.56)〕间差异有统计学意义(F=4.19,P<0.05)。PHG组、无PHG组及正常对照组MVD〔(13.76±5.35)、(10.89±2.86)和(7.68±2.45)〕间差异有统计学意义(F=8.72,P<0.05)。胃黏膜VEGF表达强度与MVD之间存在正相关关系(r=0.409,P=0.001)。结论VEGF的过度表达可能参与PHG的发生、发展,但VEGF在PHG中抗损伤作用可能是有限的。

Objective To explore the role of vascular endothelial growth factor （VEGF） in gastric mucosal vascular lesions in patients with hepatic cirrhosis （HC） portal hypertensive gastropathy （PHG）. Methods The VEGF and CD34 expressions in gastric mucosa were determined by immunohistochemistry in 48 HC PHG patients and 18 normal controls, and the mierovessel density （MVD） was counted in CD34 positive vessels. Results No PHG was found by gastroseopy in 13 patients, mild PHG in 22 and severe in 13. The positive rate of PHG was 72. 9%. PHG degree was positively related with expressions of VEGF and CD34. VEGF expression was higher in severe PHG patients than in those with mild or without, controls （ 5.76 ± 1.72, 4.65 ± 1.35, 4. 29 ±1.30, 3.64 ± 1.56, respeetively, P 〈 0.05 ）, and CD34 expression was also higher （ 16. 39± 5.60, 12. 21 ± 4.65, 10. 89± 2. 86, 7.68 ± 2.45, respectively, P 〈 0. 05 ）. VEGF expression was correlated with MVD （ r = 0. 409, P = 0. 001 ）. Conclusion The overexpression of VEGF may be involved in the occurrence and development of PHG, but its anti -injury effects may be limited in PHG.