血管内皮生长因子和促红细胞生成素在单肺通气期间的表达及意义

Expression and functional of VEGF and EPO in hypoxic metabolism during one-lung ventilation

目的探讨血管内皮生长因子(VEGF)和促红细胞生成素(EPO)在单肺通气(OLV)肺泡细胞低氧代谢的表达及其意义。方法 37例行开胸食管癌手术患者随机分为单肺通气组(OLV组)17例,双肺通气组(TLV组)20例。每组患者分别于OLV或TLV前(T1)、OLV或TLV后30min(T2)、60min(T3)、90min(T4)、120min(T5)、手术结束时(T6)抽取静脉血,检测血清VEGF、EPO水平;并分别于T1、T3、T6时点行血气分析,监测血红蛋白(HGB)水平。结果 OLV组T6时点PaO2值明显低于TLV组(P<0.05),除T1、T2外,OLV组各时点VEGF浓度均高于TLV组(P<0.05),OLV组T5、T6时点的血清EPO浓度明显高于TLV组(P<0.05)。结论在单肺通气期间VEGF和EPO因子表达明显上调,可能参与肺组织损伤及修复过程。

Objective To explore the expression and functional of the serum vascular endothelial growth factor（VEGF） and erythropoietin（EPO）in hypoxic metabolism during one-lung ventilation（OLV）. Methods Patients undergoing intrathoracic radical resection of esophageal carcinoma were randomly divided into two groups：one in which patients underwent OLV（n= 17）and another in which patients underwent two-lung ventilation（TLV;n = 20）.Blood samples were taken immediately before OLV/TLV （T1） and at 30 rain（T2）, 60 min（T3）,90 min（T4） and 120 min（T5） after the start of OLV/TLV.Venous blood was collected at the end of the surgery （T6） to measure expression levels of VEGF and EPO.HGB levels were assessed at T1 ,T3 and T6. Results PaO2 at T6 was significantly lower in the OLV group than in the TLV group （P〈0.05）.The OLV group showed significantly higher VEGF expression at T3,T4,T5 and T6,as well as significantly higher serum EPO expression at T4 and T5 than did the TLV group（P〈0.05）. Conclusion Expression of VEGF and EPO significantly increased during OLV, suggesting that they participate in the injury and/or healing of pulmonary tissue during hypoxia.