先天性心脏病伴肺动脉高压患儿血浆内皮素和血管内皮生长因子的临床研究  

Clinical study of ET-1 and VEGF in children with congenital heart disease and pulmonary hypertension

作　　者：宋海龙 曹利静[2] SONG Hai-long;CAO Li-jing(Department of Cardiac Surgery,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China;Department of Pediatric Intensive Care Unit,Hebei Children’s Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院心脏外科,河北省石家庄市050000 [2]河北省儿童医院重症医学科

出　　处：《中国心血管病研究》2023年第7期653-657,共5页Chinese Journal of Cardiovascular Research

基　　金：2022年度河北省医学科学研究课题计划(20220716)。

摘　　要：目的探讨先天性心脏病患儿血清内皮素-1(ET-1)、血管内皮生长因子(VEGF)的表达及其与肺动脉压力的相关性。方法选取2022年7月至2023年1月河北省儿童医院的70例先天性心脏病患儿,依据超声测量肺动脉压力的情况分为:无肺动脉高压(PH)组(24例)、轻度PH组(24例)及中重度PH组(22例)。抽取患儿术前及手术后撤离呼吸机24 h后的静脉血,采用ELISA法检测血清ET-1、VEGF浓度。分别比较三组血清ET-1、VEGF的浓度的差异,以及各组术前和术后血清ET-1、VEGF的浓度的差异。利用Pearson相关性分析的方法分析ET-1、VEGF的浓度与肺动脉压力的相关性。结果ET-1、VEGF浓度随着肺动脉压力上升呈提高趋势。组间比较显示,轻度PH组ET-1浓度及中重度PH组ET-1、VEGF浓度均>无PH组[(61.70±10.75)ng/L比(52.71±12.22)ng/L,P<0.05;(81.73±9.17)ng/L比(52.71±12.22)ng/L,P<0.05;(504.50±67.03)pg/ml比(451.14±73.41)pg/ml,P<0.05];组内比较,轻度PH组术后ET-1浓度及中重度PH组术后ET-1、VEGF浓度均低于术前[(55.39±7.44)ng/L比(61.70±10.75)ng/L,P<0.05;(64.19±11.85)ng/L比(81.73±9.17)ng/L,P<0.01;(469.42±56.90)pg/ml比(504.50±67.03)pg/ml,P<0.05]。二者与肺动脉收缩压均呈正相关(r=0.707,P<0.01;r=0.353,P<0.01)。结论ET-1、VEGF浓度与肺动脉压力呈正相关,因此可作为判定CHD患儿PH严重程度的预警指标。Objective To explore the expression of plasma endothelin-1(ET-1)and vascular endothelial growth factor(VEGF)and their correlation with pulmonary artery pressure in children with congenital heart disease(CHD).Methods Seventy children with CHD who had undergone radical surgeries in Hebei Children’s Hospital from 2022.7 to 2023.1 were selected and divided into no pulmonary hypertension(PH)group(24 cases),mild PH group(24 cases)and moderate to severe PH group(22 cases).The venous blood before surgery and 24 hours after withdrawal from the ventilator after surgery were collected,and the serum ET-1 and VEGF concentrations were detected by ELISA,and were compared not only among the three groups,but also before and after the surgery in each group.The correlation with pulmonary artery pressure was analyzed by Pearson correlation.Results The concentrations of ET-1 and VEGF increased with the increase of pulmonary artery pressure.Comparison between groups:the concentration of ET-1 in mild PH group,the concentrations of ET-1 and VEGF in moderate to severe PH group were higher than those in no PH group[(61.70±10.75)ng/L vs.(52.71±12.22)ng/L,P<0.05;(81.73±9.17)ng/L vs.(52.71±12.22)ng/L,P<0.05;(504.50±67.03)pg/ml vs.(451.14±73.41)pg/ml,P<0.05].Compared within groups,the concentration of ET-1 after surgery in mild PH group,the concentrations of ET-1 and VEGF in moderate to severe PH group were lower than those before the surgery[(55.39±7.44)ng/L vs.(61.70±10.75)ng/L,P<0.05;(64.19±11.85)ng/L vs.(81.73±9.17)ng/L,P<0.01;(469.42±56.90)pg/ml vs.(504.50±67.03)pg/ml,P<0.05].Both the levels of ET-1 and VEGF were positively correlated with pulmonary artery systolic blood pressure(r=0.707,P<0.01;r=0.353,P<0.01).Conclusion The concentrations of ET-1 and VEGF are positively correlated with pulmonary artery pressure,so they can be used as early warning indicators to determine the severity of PH in children with CHD.

关 键 词：先天性心脏病 内皮素-1 血管内皮生长因子 肺动脉高压 

分 类 号：R714.5[医药卫生—妇产科学]