血管内皮生长因子及其+405G/C基因多态性与急性肺损伤的相关性

Relationship between the serum levels of VEGF and VEGF+405G/C gene polymorphism in patients with acute lung injury

目的探讨血管内皮生长因子(VEGF)及VEGF(+405G/C)基因多态性与急性肺损伤(ALI)的相关性。方法收集2009年6月至2011年12月我院重症监护室(ICU)收治ALI患者的临床资料,计算急性生理和慢性健康评分(APACHEⅡ评分)和氧合指数;采用酶联免疫吸附试验(ELISA)方法检测ALI患者及对照组血清VEGF水平;采用聚合酶链反应-限制片段长度多态性技术(PCR-RFLP),检测ALI患者及对照组VEGF(+405G/C)基因多态性。结果血清VEGF水平ALI组显著高于对照组[分别为(151±76)pg/mL和(112±45)pg/mL,P=0.002];血清VEGF水平与APACHEⅡ评分呈正相关(r=0.337,P=0.017);ALI组与对照组相比,CC基因型频率(28%)、GC基因型频率(60%)和C等位基因频率(58%)显著高于对照组[分别为24%(P=0.009)、38%(P=0.009)和43%(P=0.034)],C等位基因个体的ALI相对风险度增加(OR=1.83,95%CI为1.04～3.19)。结论血清VEGF水平在ALI早期升高,VEGF可以反映ALI严重程度;VEGF基因多态性与ALI有关联,VEGF(+405C)等位基因可能是ALI的易感基因。

Objective To examine the gene polymorphism, serum protein levels of vascular endothelial growth factor （VEGF） and the risk for acute lung injury （ALI）. Methods The clinical materials of acute lung in- jury patients, who were hospitalized in ICU of our hospital from June 2009 to December 2011 were collected, and APACHE Ⅱ score and oxygenation index were calculated. Serum VEGF levels in the acute lung injury patients and control group were examined by ELISA. PCR-RFLP was used to analyze the gene polymorphisms of VEGF （4-405G/C） in patients of ALI and control group. Results The serum levels of VEGF in acute lung injury pa- tients are obviously higher than those in the control group [（151±76）pg/mL and （112±45）pg/mL,P=0. 001]; The VEGF serum levels showed obvious positive correlation with APACHE ]1 score （r= 0. 337, P= 0. 017） ; The distribution of CC genotype frequency （28%）, GC genotype frequency （60%） and C allele frequency （58%） is significantly higher than that in controls[24%（P=0. 009）, 38% （P=0. 009） and 34% （P=0. 034）, respective- ly], the relative risk of suffering from ALI of （＋405C） allele gene carrier was increased （OR = 1.83,95 % CI： 1.04-3.19）. Conclusion The serum levels of VEGF are elevated in acute lung injury patients at early stage and the serum levels of VEGF can be used as an indicator of the severity of acute lung injury. VEGF （A-405C） allele may be one risk factor to ALL