血管内皮生长因子在慢性阻塞性肺疾病肺动脉高压痰液中的检测及临床意义

Clinical value of detecting vascular endothelial growth factor in sputum of patients withpulmonary arterial hypertension associated with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病（COPD）肺动脉高压患者痰液中血管内皮生长因子（VEGF）的变化及临床意义。方法采用酶联免疫吸附试验（EusA）方法检测52例稳定期COPD肺动脉高压患者（A组）、60例单纯稳定期COPD患者（B组）以及50例健康查体者（c组）痰液中VEGF水平。并对其肺功能、动脉血气分析及肺动脉收缩压（PAsP）进行检测。结果A、B、C三组VEGF水平分别为（4．30±0．93）、（2．64±0．57）、（1．48±0．32）肛g／L，各组之间比较差异有统计学意义（F=31．612，P〈0．01）；第1秒用力呼气容积（FEv。）占预计值的百分比（FEV．％）分别为（48．68±10．53）％、（67．56±14．61）％、（101．60±21．97）％，各组之间比较差异有统计学意义（F=28．983，P〈0．01）；PAsP分另U为（55．02±11．90）、（23．50±5．08）、（16．16±3．49）mmHg（1mmHg=0．133kPa），各组之间比较差异有统计学意义（F=34．887，P〈0．01）；而各组之间动脉血氧分压（PaO：）、动脉血二氧化碳分压（PaCO：）比较差异无统计学意义（F=2．159、3．167，P〉O．05）。VEGF水平与FEV。％呈显著负相关（r=-0．562，P〈0．05），VEGF水平与PASP呈显著正相关（r=0．783，P〈O．05），而VEGF水平与PaO：、PaCO：无相关性（r=-0．318、O．275，P〉0．05）。结论COPD肺动脉高压患者痰液中存在VEGF的高表达，VEGF水平与肺功能、PASP显著相关，VEGF在COPD肺动脉高压的发病过程中起着重要的作用。

Objective To study the changes and clinical significance of vascular endothelial growth factor （VEGF） in sputum of patients with pulmonary arterial hypertension associated with chronic obstructive pulmonary disease （COPD）. Methods The sputum VEGF levels of 52 cases with pulmonary arterial hypertension associated with COPD during stable period （group A）, 60 cases with COPD during stable period （group B ） and 50 normal persons （group C） were detected by enzyme linked immunosorbent assay （ELISA） method. The pulmonary function, arterial blood gas analysis and pulmonary artery systolic pressure （PASP） were detected. Results The sputum VEGF levels of group A, B and C were （4.30 ± 0.93）, （2.64 ± 0.57） and （ 1.48 ± 0.32） p± g/L respectively, which had significant difference （F = 31.612, P 〈 0.01 ）. The percentage of forced expiratory volume in the first second （FEV±） in predicted value （FEV1%） of group A, B and C were （48.68 ± 10.53）%, （67.56 ± 14.61 ）%, （101.60 ± 21.97）% respectively,which had significant difference （F = 28.983, P 〈 0.01 ）, as well as PASP had [ （55.02 ± 11.90）, （23.50 ± 5.08 ）, （ 16.16 ± 3.49） mm Hg （ 1 mm Hg = 0.133 kPa） ,F = 34.887,P 〈 0.01 ]. The arterial partial pressure of oxygen （PaO2） and carbondioxide （PaC 02 ） of three groups had no significant difference （ F = 2.159,3.167, P 〉 0.05 ）. The sputum VE GF level had significantly negative correlation with FEV1%＇（r =-0.562, P 〈 0.05 ）, and positive correlation with PASP （r =0.783,P 〈0.05）,while had no correlation with PaO2,PaCO2 （r =-0.318,0.275,P 〉0.05）. Conehmions The sputum VEGF level of patients with pulmonary arterial hypertension associated with COPD expresses high level, which has significant correlation with pulmonary function and PASP. Therefore, VEGF plays an important role in the pathogenesis of pulmonary arterial hypertension associated with COPD.