门静脉高压症患者食管壁组织血管新生和内脏血流动力学的关系  

Angiogenesis in esophagus of patients with portal hypertension and its relationship with splanchnic hemodynamics

作　　者：潘一明[1] 黄旭[1] 曹亚娟[1] 包善华[1] 谢敏[1] 

机构地区：[1]南京大学医学院附属鼓楼医院普通外科,江苏省210008

出　　处：《江苏医药》2014年第16期1895-1898,共4页Jiangsu Medical Journal

摘　　要：目的探讨门静脉高压症患者食管壁组织血管内皮生长因子(VEGF)的表达和微血管密度(MVD)计数及其与内脏血流动力学的关系。方法 36例门静脉高压症患者术前测量门静脉和脾静脉直径(D)及平均流速(V),计算流量(Q)。术中测量自由门静脉压力(FPP),并留取食管壁组织行VEGF和CD31免疫组化半定量分析,计算MVD。依据食管壁组织VEGF阳性表达量,VEGF阳性表达患者分为VEGF高表达组和VEGF低表达组。结果食管壁组织VEGF阳性表达率为91.7%。食管壁组织VEGF高表达组门静脉内径(Dp)和流量(Qp)、脾静脉内径(Ds)和流量(Qs)高于低表达组(P<0.01);VEGF高表达组的FPP高于低表达组(P<0.01)。36例患者食管壁组织MVD计数为12.98±4.74,与Dp、Qp、Ds和Qs呈正相关(P<0.01)。结论门静脉高压症患者食管壁组织中VEGF的高表达和MVD与内脏血流动力学指标密切相关。Objective To explore the expression of vascular endothelial growth factor（VEGF）and microvessel density（MVD）in the esophagus of patients with portal hypertension and their relationship with the splanchnic hemodynamics.Methods The diameter（D）and mean flow rate（V）of portal vein and splenic vein in 36 patiens undergoing selective devascularization were measured and the quantity of blood flow（Q）was calculated before operation.During operation,the free portal hypertension（FPP）was measured and esophagus tissues were taken for detecting the expressions of VEGF and CD31 by immunohistochemistry.MVD of esophagus tissues was calculated.On the basis of VEGF expression rate,the cases with positive VEGF expression were divided into two groups of A（with high VEGF expression）and B（with low VEGF expression）.Results The overall positive expression rate of VEGF in esophagus tissues was 91.7%.The diameter and flow of portal vein（Dp and Qp）and splenic vein（Ds and Qs）were higher,but FPP was lower,in group A than those in group B（P〈0.01）.The MVD in esophagus tissues of 36 cases was 12.98±4.74,which was positively correlated with Dp,Qp,Ds and Qs（P〈0.01）,but not significantly correlated with Vp and Vs（P〉0.05）.Conclusion The high VEGF expression and MVD in esophagus tissues are closely related to the parameters of splanchnic hemodynamics in the patients with portal hypertension.

关 键 词：门静脉高压症 血管内皮生长因子 内脏血流动力学 

分 类 号：R657[医药卫生—外科学]