支气管肺发育不良早产儿肝细胞生长因子、血管内皮生长因子水平变化及其相关性  

Dynamic levels of hepatocyte growth factor and vascular endothelial growth factor in the development of bronchopulmonary dysplasia

作　　者：高原[1] 刘花兰[2,3] 包云光[1] 赵婵[1] 余波[2] 林振浪[2] 

机构地区：[1]浙江省金华市中心医院儿科,321000 [2]浙江省温州医科大学附属二院育英儿童医院新生儿科,325027 [3]浙江省宁波妇女儿童医院儿科,315012

出　　处：《中华妇幼临床医学杂志（电子版）》2015年第3期48-52,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：浙江省重点科技创新团队自主立项项目(2010R50045-2)~~

摘　　要：目的探讨发生支气管肺发育不良（BPD）的早产儿支气管肺泡灌洗液（BALF）中肝细胞生长因子（HGF）和血管内皮生长因子（VEGF）表达水平变化及其相关性。方法选择2009年10月至2013年6月浙江省金华市中心医院（浙江大学金华医院）和温州医科大学附属二院育英儿童医院收治的生后24h内行气管插管呼吸机辅助治疗的60例早产儿为研究对象。根据早产儿是否为BPD,将其分为BPD组（n=22）和非BPD组（n=38）。两组患儿的胎龄、出生体质量、性别构成比、生后5min Apagar评分、肺表面活性物质（PS）应用次数等一般临床资料比较,差异无统计学意义（P〉0.05）。两组患儿均于在气管插管拔除之前采集BALF,采集时间点分别在生后第1,3,7,14天。采用酶联免疫吸附测定（ELISA）法测定BALF上清液中HGF、VEGF及sIgA水平,并对两组进行对比分析。本研究遵循的程序符合金华市中心医院（浙江大学金华医院）和温州医科大学附属二院育英儿童医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人的知情同意,并与之签署临床研究知情同意书。结果 ①BPD组患儿接受呼吸机治疗时间明显较非BPD组长（Z=3.283,P=0.001）。②早产儿生后2周内不同时间点,BPD组患儿BALF中HGF及VEGF水平均低于非BPD组（P〈0.05）,且随着日龄的增加,BPD组的HGF水平逐渐下降,而VEGF水平逐渐升高。③出生后第3天HGF及VEGF水平与BPD转归呈负相关关系（OR=0.806,95%CI：0.764～0.851,P〈0.01;OR=0.288,95%CI：0.189～0.439,P〈0.01）。结论BPD早产儿BALF中HGF、VEGF水平明显低于非BPD早产儿。出生后第3天的HGF、VEGF低水平表达与BPD发生具有相关性。Objective To investigate the dynamic levels of hepatocyte growth factor（HGF）,vascular endothelial growth factor（VEGF）in bronchopulmonary dysplasia（BPD）,so that to reveal the relationship between two growth factors and BPD.Methods Sixty preterm newborns（〈32 weeks′gestation）who visited the department of Pediatrics,Jinhua Central Hospital and The 2nd Affiliated Hospital Yuying Children′s Hospital of Wenzhou Medical University from October 2009 to June 2013 were included in this study.All of them were received mechanical ventilation within 24 hafter birth.They were divided into BPD group（n=22）and BPD-free group（n=38）according to the diagnostic criteria of BPD.There were no significant differences between two groups in the aspects of gestational weeks,birth weight,constituent ratio of gender,5min Apgar scores and application numbers of pulmonary surfactant（PS）,and so on（P〉0.05）.Bronchoalveolar lavage fluid（BALF）samples were collected from 60 ventilated preterm infants on1 st,3rd,7th,14 th day after birth.The levels of HGF,VEGF and secreted immunoglobulin（sIg）A were quantified by enzyme linked immunosorbent assay（ELISA）,at the same time,clinical information were collected.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Jinhua Central Hospital and The 2nd Affiliated Hospital Yuying Children′s Hospital of Wenzhou Medical University. Informed consent was obtained from the parents of each participating child.Results ①Ventilator therapy duration in BPD group was significantly longer than that in BPD-free group（Z=3.283,P=0.001）.②BPD group has lower levels of VEGF and HGF than those in BPD-free group at four different time-points（P〈0.05）,while the levels of VEGF became higher and higher,and the levels of HGF became lower and lower.The levels of HGF and VEGF on the 3rd day after birth showed negative connection with BPD（OR=0.806,95%CI：0.764～0.851,P〈0.01;OR=0.288,95%CI：0.189～0.439,P〈0.01）.Conclusion

关 键 词：支气管肺发育不良 肝细胞生长因子 血管内皮生长因子 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]