严重肺挫伤患者血浆血管内皮生长因子的动态变化及其临床意义

Dynamic changes and significance of vascular endothelial growth factor in severe pulmonary contusion

目的通过检测严重肺挫伤患者血浆血管内皮生长因子（VEGF）在受伤后不同时点的浓度，揭示其动态变化规律及对病情变化和预后的影响。方法将63例严重肺挫伤患者根据急性肺损伤／急性呼吸窘迫综合征（ALVARDS）诊断标准分成ALVARDS组（A组）和非ALL／ARDS组（B组）两组，并引入阳性对照组（C组）和正常对照组（D组），使用EHSA法分别检测伤后24h内及第3、5、7天时的血浆VEGF浓度，观察其动态规律，并比较各组的临床结果。结果严重肺挫伤患者血浆VEGF浓度呈动态变化，发病后即升高，第5天达高峰，第7天下降；严重肺挫伤ALUARDS组早期死亡率明显增加。结论严重肺挫伤患者血浆VEGF浓度呈动态变化，动态血浆VEGF浓度可以作为严重肺挫伤后ARDS的预测及预后指标。

Objective To detect the dynamic changes of vascular endothelial growth factor （VEGF） level and its influence on the condition and prognosis of severe pulmonary contusion at different time points after injuries. Methods According to the diagnostic standard of acute lung injury/acute respiratory distress syndrome （ALI/ARDS）, 63 cases of severe pulmonary contusion were divided into two groups： severe pulmonary contusion with ALI/ARDS （group A） and severe pulmonary contusion without ALI/ARDS （group B）. And there was a positive control group （group C） and normal control group （ group D）. The plasma VEGF level was detected by double - antibody sandwich enzyme - linked immunosorbent assay （ELISA） at days of 1, 3, 5 and 7, respectively. Its dynamic regularity was observed and the clinical results of each group were compared. Results The plasma VEGF level dynamically changed in severe pulmonary contusion, it rose immediately after injury and the highest expression occurred at day 5, but it descended at day 7. The mortality of earlier period was markedly increased in severe pulmonary contusion with ALI/ARDS. Conclusion The plasma VEGF level dynamically changes in severe pulmonary contusion and its level may be as an indicator for prediction and prognosis of ALI/ARDS caused by severe pulmonary contusion.