血管内皮生长因子在先天性心脏病肺动脉高压中的表达及意义

Expression and clinical significance of vascular endothelial growth factor in congenital heart disease with pulmonary hypertension

目的 :探讨血管内皮生长因子 (VEGF)在先天性心脏病 (CHD)肺动脉高压形成和发展中的意义。方法 :采用ELISA方法检测并比较 5 0例CHD患儿 [其中无肺动脉高压组 (肺动脉收缩压 <30mmHg) 15例 ,轻度肺动脉高压组 (肺动脉收缩压 30～ 4 9mmHg) 19例 ,中重度肺动脉高压组 (肺动脉收缩压 >5 0mmHg) 16例 ]和 18例健康患儿的血清VEGF。结果 :轻度肺动脉高压组VEGF[(10 4 .5 4± 30 .5 5 )pg/ml]明显高于无肺动脉高压组 [(2 8.2 3± 13.4 7)pg/ml];中重度肺动脉高压组 [(189.2 4± 4 3.89)pg/ml]明显高于轻度肺动脉高压组[(10 4 .5 4± 30 .5 5 )pg/ml];无肺动脉高压组 [(2 8.2 3± 13.4 7)pg/ml]与正常对照组 [(2 5 .5 6± 10 .6 7)pg/ml]相比 ,差异无显著性 (P >0 .0 5 )。血清VEGF浓度与肺动脉收缩压呈正相关 (r=0 .783)。结论 :VEGF在CHD肺动脉高压血管重建中起重要作用 ,CHD肺动脉高压患儿血清VEGF浓度升高 ,提示VEGF与肺动脉高压的病理生理有关。

Objective:To investigate the formation and clicilinal significance of the vascular endothelial growth factor(VEGF) in the development of congenital heart disease with pulmonary hypertension(PH) Methods:Fifty children with congenital heart disease[in these patients,non-PH group in which pulmonary artery systolic pressure(PASP) was <30 mmHg(n=15),mild-PH group in which PASP was 31～49 mmHg(n=19),moderate or severe-PH group in which PASP was >50 mmHg(n=16)] and 18 healthy controls were enrolled in the study. Serum VEGF concentration was measured with enzyme-linked immunosorbant assay.Results: Mean VEGF(104.54±30.55)pg/ml of patients with mild pulmonary hypertension were significantly greater than that of patients with no pulmonary hypertension(28.23±13.47)pg/ml(P<0.01);mean VEGF(189.24±43.89)pg/ml of patients with moderate or severe pulmonary hypertension had significantly greater than that of patients with mild pulmonary hypertension(104.54±30.55)pg/ml(P<0.01);the mean VEGF between patients with no pulmonary hypertension(28.23±13.47)pg/ml and healthy controls(25.56±10.67)pg/ml had no significance(P>0.05). VEGF concentration and pulmonary artery pressure were positively correlated(r=0.783).Conclusion:Serum VEGF concentration in children with congenital heart disease with pulmonary hypertension is much higher than that in control group. VEGF is probably involved in the pathophysiology and vascular remodeling of pulmonary hypertension.