血清缺氧诱导因子-1α和血管内皮生长因子水平与高原慢性肺心病患者肺动脉压的关系  

Change in Serum Hypoxia Inducible Factor-1α and Vascular Endothelial Growth Factor and Its Relationship to Pulmonary Arterial Pressure in Patients with Acute Exacerbation of Chronic Cor Pulmonale on Plateau

作　　者：杨生岳[1] 罗晓红[2] 郭振援[1] 冯恩志[1] 殷和[1] 刘睿年[1] 张瑛[1] 田忠新[1] 

机构地区：[1]解放军第四医院兰州军区呼吸内科中心,青海西宁810007 [2]兰州军区疾病预防控制中心,甘肃兰州730007

出　　处：《中国临床医学》2010年第6期775-777,共3页Chinese Journal of Clinical Medicine

基　　金：青海省重点科技攻关项目(编号:2006-N-143)

摘　　要：目的：探讨血清缺氧诱导因子-1α（HIF-1α）和血管内皮生长因子（VEGF）在低氧性肺动脉高压发病中的作用。方法：采用双抗体夹心酶联免疫吸附法（ELSIA）检测高原地区（海拔2 260~3 500m）50例慢性肺心病急性加重期患者（肺心病组）、40例慢性阻塞性肺疾病（COPD）缓解期患者COPD组和40例当地健康体检者（对照组）血清HIF-1α、VEGF含量、动脉血氧分压（PaO2）,并使用彩色多普勒超声心动仪测定肺动脉血流频谱,计算平均肺动脉压（mPAP）。结果：肺心病组血清HIF-1α（325.88±38.02）pg.L-1、VEGF（466.40±52.44）ng.L-1,mPAP（46.22±5.34）mmHg显著高于COPD组[分别为（74.02±8.15）pg.L-1、（98.51±8.22）ng.L-1和（24.77±2.54）mmHg];COPD组显著高于健康对照组[分别为（54.85±7.72）pg.L-1、（74.57±7.58）ng.L-1和（21.47±2.35）mmHg]。肺心病组PaO2（37.21±4.35）mmHg显著低于COPD组（59.21±5.24）mmHg,COPD组显著低于健康对照组（67.35±4.67）mmHg。肺心病组和COPD组血清HIF-1α、VEGF水平与mPAP均呈正相关,与PaO2水平呈负相关。结论：高原慢性肺心病急性加重期患者血清HIF-1α、VEGF水平明显升高,可能与其低氧性肺动脉高压的形成有一定关系。Objective：To assess the role of serum hypoxia inducible factor-1α（HIF-1α）and vascular endothelial growth factor（VEGF） in the development of hypoxic pulmonary hypertension in the patients with chronic cor pulmonale on highland.Methods： The levels of HIF-1α and VEGF in serum of 50 patients with chronic cor pulmonale in the acute exacerbation stage,40 patients with chronic obstructive pulmonary disease（COPD） in the remission stage and 40 normal control subjects were measured by sand wich enzym-linked immunoadsorbent assay（ELISA）.The mean pulmonary arterial pressure（mPAP） was measured by echocardiography.The partial pressure of oxygen in artery blood（PaO2） was measured by blood gas analyzer.Results： The level of serum HIF-1α [（325.88±38.02）pg·L-1],VEGF [（466.40±52.44）ng·L-1] and mPAP [（46.22±5.34）mmHg] in the patients with chronic cor pulmonale were significantly higher than those in the patients with COPD [（74.02±8.15）pg·L-1,（98.51±8.22）ng·L-1 and（24.77±2.54）mmHg,respectively,all P0.01],those of the patients with COPD were significantly higher than those the normal control subjects [（54.85±7.72）pg·L-1,（74.57±7.58）ng·L-1 and（21.47±2.35）mmHg,respectively,all P0.01].The PaO2 [（37.21±4.35）mmHg ] in the patients with chronic cor pulmonale was significantly lower than that in patients with COPD and normal subjects [（59.21±5.24）mmHg）mmHg and（67.35±4.67）mmHg,respectively,all P0.01].The levels of serum HIF-1α and VEGF in the patients with chronic cor pulmonale and the patients with COPD was positively correled with mPAP,netatively correlated with PaO2.Conclusions： The level of serum HIF-1α and VEGF in patients with chronic cor pulmonale on highland is significantly increased;it may play an important role in the process of sustained hypoxic pulmonary hypertension in patients with chronic cor pulmonale on highland.

关 键 词：缺氧诱导因子 血管内皮生长因子 慢性肺源性心脏病 慢性阻塞性肺疾病 

分 类 号：R541.5[医药卫生—心血管疾病]