皮肤血管瘤患儿脉冲激光治疗前后外周血生长因子的变化

Changes of peripheral vascular growth factors of patients with cutaneous hemangioma after treatment with pulse laser

目的对比分析皮肤血管瘤患儿脉冲激光治疗前后外周血血管内皮生长因子(VEGF)、转化生长因子(TGF-β1)及碱性成纤维细胞生长因子(b FGF)的表达变化。方法选取皮肤血管瘤患儿73例(增生期35例、消退期17例、消退完成期21例)及非血管性皮肤病患儿22例(对照组),所有增生期皮肤血管瘤患儿均采用脉冲染料激光进行治疗;取外周静脉血,检测VEGF、TGF-β1及b FGF的mRNA表达水平及蛋白含量。结果治疗前,增生期患儿的VEGF、TGF-β1及b FGF的mRNA表达水平和蛋白含量高于消退期,消退期高于消退完成期与对照组,差异均有统计学意义(P<0.05),消退完成期和对照组之间无统计学差异(P>0.05)。治疗后,增生期患儿VEGF、TGF-β1及b FGF的mRNA表达水平和蛋白含量均显著低于治疗前(P<0.05)。结论脉冲染料激光可下调皮肤血管瘤患儿外周血VEGF、TGF-β1及b FGF的mRNA表达水平,从而减少各蛋白分泌,可能为其发挥治疗作用的重要机制之一。

Objective To analyze the serum expression levels of vascular endothelial growth factor（ VEGF）,transforming growth factor beta 1（ TGF-β1） and basic fibroblast growth factor（ b FGF） of children with cutaneous hemangioma before and after treatment with pulse laser. Method 73 patients with cutaneous hemangioma（ including 35 cases of proliferative stage,17 cases of fading stage,and 21 cases of faded stage） and 22 children（ as the control group） with non-vascular dermatosis were chosen as subjects of study. All children of proliferative stage were treated with pulse laser. The peripheral venous blood of all the patients were extracted to detect the mRNA expression level and protein content of VEGF,TGF-β1and b FGF. Findings Before treatment,the VEGF,TGF-β1 and b FGF mRNA expression levels and protein contents of patients of proliferative stage were higher than those in the fading stage,and those in the fading stage were higher than those in the faded stage and the control group. The differences had statistical significance（ P〈 0. 05）. There was no significant difference between patients in the faded stage and the control group（ P〉 0. 05）. After treatment,the VEGF,TGF-β1 and b FGF mRNA expression levels and protein contents of patients in the proliferative stage were lower than shoes before treatment,and the difference had statistical significance（ P〈 0. 05）. Conclusion Pulse laser as a treatment means can down-regulate the VEGF,TGF-β1 and b FGF mRNA expression and reduce the protein secretion,which can serve as one critical mechanism for treating cutaneous hemangioma.