层粘连蛋白和血管内皮生长因子受体-2在脑动静脉畸形出血中的表达及意义

The Expression and the Significance of Laminin and Vascular Endothelial Growth Factor Receptor-2in the Cerebral Arteriovenous Malformation

目的 探讨高血流动力学状态对脑动静脉畸形（cAVM）血管重塑的影响.方法 收集7例颅脑外伤病人内减压术后的脑组织做为正常对照组,另选择27例脑动静脉畸形出血病人开颅切除术后的脑组织病理蜡块,按其并发症的有无及不同分为单纯AVM组、AVM合并糖尿病组、AVM合并高血压组,计算各病例的肱动脉平均动脉压,HE染色后观察组织形态,免疫组化染色后观察层粘连蛋白（LN）和VEGFR-2阳性表达及分布.结果 LN表达量和VEGFR-2表达量在组间比较中差异均有显著性（P〈0.01）.LN的表达量在各组的两两比较中,正常对照组与各AVM组相比,单纯AVM组与AVM合并高血压组相比,差异有显著性（P〈0.05）.VEGFR-2表达量在各组的两两比较中,正常对照组与各AVM组相比,差异有显著性（P〈0.01）.LN和平均动脉压的Pearson相关系数有显著性（P〈0.01）,VEGFR-2和平均动脉压的Pearson相关系数差异无显著性（P〉0.01）.结论 脑AVM出血的畸形血管能表达过量且分布异常的层粘连蛋白,其表达量与平均动脉压之间存在正相关;AVM出血的畸形血管中VEGFR-2表达量显著增多,其表达量与平均动脉压之间无明显相关性.

Objective To investigate the influence of high hemodynamics on the expression of laminin（LN） and VEGFR-2 in cerebral arteriovenuus malfi）rmation（cAVM） and its clinical significance. Methods Seven patients rescued ]）y decompression surgery because of craniocerebral in.injury were collected as the control group. Twenty-seven patients with cAVM hemorrhaging were divided into three groups according to the different complications,that were the simple AVM group,AVM merging hypertension group, AVM merging diabetes group. To calculate the mean arterial hh）od pressure of all cases,to detect the expression and distril）ution of LN and VEGFR-2 in cAVM and nnrmal brain tissue hy HE staining and immunohistochemistry. Results The differences in expression of LN and VECFR-2 between groups were significantly statistical（ P 〈0.01）. The differences in expression of LN between the control group and AVM groups,between the simple AVM group and AVM merging hypertension group,were significantly statistical（ P 〈 0.05）. The differences in expression of VEGFR-2 between the control group and AVM groups were significantly statistical（ P 〈 0.0It. The correlation coefficient of LN to the mean arterial blood pressure was significantly statistical（ P 〈 0.01 ） tested by the Pearson linear correlation analysis,while that of VEGFR-2 to the mean arterial bh）nd pressure was not significantly statistical（ P 〉 0.01 ）. Conclusion There was an overexpression of laminin in vascular of cAVM, anti the expression level was positively related to mean arterial pressure. The expression of VEGFR-2 in vascular of cAVM was increased significantly, and the expression level was not positively related to mean arterial pressure.