【摘要】 目的观测先天性心脏病(CHD)和肺动脉高压(PH)患者血浆中血管内皮生长因子(VEGF)的浓度变化,探讨其在CHD肺高压形成和发展中的作用机制。方法选择70例左向右分流CHD患者和20例非CHD患者分别作为CHD患病组及对照组。根据肺动脉压的不同,将CHD患者分为CHD不伴有PH组(25例)、轻度PH组(21例)、中重度PH组(24例)。用ELISA法测定各组血清中VEGF的浓度。做肺组织活检观察肺血管的病理改变。结果 CHD组血清VEGF水平(2.35±1.03pg/mL)明显高于对照组(1.89±0.25pg/mL,P<0.05);且VEGF的浓度随着肺动脉压力的升高而增加,CHD不伴有PH组(1.83±0.52pg/mL)、轻度PH组(2.62±0.79pg/mL)及中重度PH组(2.66±1.37pg/mL)VEGF浓度间有显著统计学差异(P<0.01)。CHD组血管中膜厚度(mMTPA)较对照组明显增厚(29.45%±13.53%,9.74%±2.86%,P<0.01)。VEGF的浓度与平均肺动脉压(MPAP)和肺小动脉中膜厚度呈正相关(r=0.380,P<0.01;r=0.448,P<0.05);与血管壁面积/血管总面积(WA/TA)呈正相关(r=0.763,P<0.01)和血管腔面积/血管总面积(EA/TA)呈负相关(r=-0.691,P<0.01)。结论 VEGF参与和促进了CHD肺动脉高压的形成和发展。更多还原

【Abstract】 Objective To investigate the changes of serum endothelial growth factors(VEGF) and the pulmonary vessel thickness in patients with congenital heart disease(CHD)complicated with pulmonary hypertension(PH).Methods 70 CHD patients were selected as experimental group and 20 non-CHD cases as control group;according to the levels of pulmonary arterial pressure,divided CHD patients into CHD with no PH group(25 cases),CHD with slight PH group(21 cases) and CHD with mild or severe PH group(24 cases).The concentrations of VEGF were detected by ELISA.The pulmonary vessel pathological changes were observed by micromorphometric method.Results VEGF level of CHD group was2.35±1.03pg/ml,significantly higher(P<0.05) than that of control group(1.89±0.25pg/ml);Along with the risen of pulmonary artery pressure,the level of VEGF was increasing.VEGF levels of CHD with mild PH group(2.62±0.79pg/ml) and CHD with severe PH group(2.66±1.37pg/ml) were higher than that of CHD with no PH group(1.83±0.52pg/ml).Compared with normal cases without CHD group(9.74±2.86%),mean medial thickness in pulmonary arterioles(mMTPA) of CHD group(29.45±13.53%) was significantly thicker(P<0.01).The concentration of VEGF was positively correlated with MPPA(r=0.380,p<0.05);mMTPA(r=0.448,P<0.05)and relative ration of vessel wall area/total(WA/TA) r=0.763,P<0.01),but negatively correlated with the relative ratios of vessel lumen area/total area(EA/TA)(r=-0.691,P<0.01).Conclusion VEGF takes part in the construction and development of pulmonary hypertension in CHD patients.更多还原