成人先天性心脏病伴肺动脉高压患者血浆VEGF与TGF-β1浓度变化的相关研究  

Correlative Study Between Plasma VEGF and TGF-β1 in Adult Patients with Congenital Heart Disease and Pul- monary Artery Hypertension

作　　者：赵延恕[1] 冯莉莉[1] 吕小玲[1] 聂赛[1] 

机构地区：[1]中南大学湘雅二医院心内科,湖南长沙410011

出　　处：《医学临床研究》2013年第11期2154-2157,共4页Journal of Clinical Research

摘　　要：【目的】探讨成人先天性心脏病（CHD）并肺动脉高压（PAH）患者血浆中血管内皮生长因子（VEGF）和转化生长因子-β1TGF-β1）的浓度水平在疾病过程中的临床意义及价值。【方法】选择本院心内科、心胸外科收治的78例成人左向右分流型CHD患者均在右心导管检查中直接测定肺动脉平均压（mPAP），按mPAP水平分为无PAH组（mPAP≤25mm-Hg）20例、轻度PAH组（25mmHg〈mPAP≤35mmHg）21例、中度PAH组（35mmHg〈mPAP≤45mmHg）14例及重度PAH组（mPAP〉45mmHg）23例。取患者主肺动脉血。选择同期心内科收治的预行射频消融术患者10例为正常对照组。对照组于清晨空腹状态下行射频消融术时抽股静脉血4m1。采用酶联免疫吸附法（ELISA）测定其肺动脉血浆VEGF及TGF-β1水平，分析二者与mPAP的关系。【结果】CHD组血浆VEGF及TGF-β1均显著高于对照组（P〈0．01）。四组患者肺动脉血浆VEGF水平和TGF-β1水平组间比较差异均有统计学意义（F=449．078，P〈0．05），（F=57．347，P〈0．05）；肺动脉血浆VEGF浓度水平与mPAP呈正相关（r=0．814，P〈0．05）；肺动脉血浆TGF-β1浓度水平与mPAP呈正相关（r=0．723，P〈0．05）；患者血浆VEGF与TGF-β1水平呈正相关（r=0．758，P〈0．05）。【结论】VEGF及TGFBl参与了左向右分流型CHD并PAH的病理生理过程，其血浆水平可作为评估左向右分流型cHD患者PAH严重程度的参考指标之一。VEGF及TGF-β1对监测PAH发生发展动态变化过程有一定意义及临床价值。[Objective]To explore the levels of plasma vascular endothelial growth factor（VEGF） and transform growth factor-β1 （TGF-131） in adult patients with congenital heart disease（CHD） and pulmonary arterial hypertension（PAH） and their clinical significance and value. [Methods]A total of 78 adult patients with left-to-right shunt type CHD admitted in cardiology department and thoracic surgery department were chosen. According to mean pulmonary artery pressure（mPAP） directly de- tected by right heart catheterization, all patients were divided into non-PAH group （mPAP≤25mmHg, n=20）, mild PAH group（25mmHgGmPAP≤35mmHg, n = 21）, moderate PAH group（35mmHgGmPAP≤45 mmHg, n=14） and severe PAH group （mPAP〉45mmHg, n = 23）. Pulmonary artery blood was collected. Other 10 concurrent patients scheduled for radiofre- quency ablation in cardiology department was chosen as normal control group. When radiofrequency ablation was performed un- der fasting status in the morning, femoral venous blood 4ml in control group was drawn. The levels of VEGF and TGF-β1 were measured by using enzyme linked immunosorbent assay（ELISA）. The relationship of VEGF and TGF-β1 with mPAP was ana- lyzed. [Results] The levels of plasma VEGF and TGF-β1 in CHD group were significantly higher than those in control group（ P〈0.01）. There were significant differences in the levels of plasma VEGF and TGF-β1 in pulmonary artery among four groups （F=449. 078, P G0.05 or F=57. 347, P〈0.05）. The level of plasma VEGF in pulmonary artery was positively correlated with mPAP（r=0. 814, P G0.05）. The level of plasma TGF-β1 in pulmonary artery was positively correlated with mPAP（r= 0. 723, P G0.05）. The level of plasma VEGF was positively correlated with the level of TGF-β1（r=0. 758, P 〈0.05）. [Con- clusion]VEGF and TGF-β1 involve in the physiological processes of CHD combined with PAH. The level of VEGF and TGF-β1 can be taken as one of the indicators to evaluate the severity of PAH in patients wi

关 键 词：心脏病 并发症 高血压 肺性 并发症 血管内皮生长因子A 血液 转化生长因子β BL 

分 类 号：R541[医药卫生—心血管疾病]