血清缺氧诱导因子-1α和血管内皮生长因子水平与高原肺水肿患者肺动脉压的关系

摘要

Objective To assess the role of serum hypoxia inducible factor-I ct ( HIF-1 ct) and vascular endothelial growth factor (VEGF) in the development of hypoxic pulmonary hypertension in the patients with high altitude pulmoary edema( HAPE ). Methods The levels of serum HIF-I ct. VEGF, mean pulmonary arterial hypertension (mPAP)and partial pressure of oxygen in artery blood (PaO2 )wasmeasured in of 22 patients with HAPE before treatment and after cure. Another,the upper mentioned parameters were meated in 30healthy peoples. Results Before treatment, the level of serum HIF-I ct, VEGF and mPAP in the patients with HAPE were significantly higher than those in the the normal control subjects( all P ＜ 0. O1 ). The levels of serum HIF-I αt and VEGF was positively correled with mPAP( r = 0. 826、0. 831, respectively, all P ＜ 0. 01 ), PaO2 was netatively correlated with mPAP( r= -0. 796,P ＜ 0. O l )in the patients with HAPE. The after cure, the levels of serum HIF-Iα,VEGF and mPAP were significantly higher than those before treatment ( all P ＜O. 01 ), PaO2 was significantly lower than that before cure ( all P ＜0. 01 ) in the patients with HAPE. The after cure, all parameters in the patients with HAPE were not significantly differcence compared with those the normal control subjects ( allP ＞ O. 05 ). Conclusion The level of serum HIF-iα and VEGF in patients with HAPE is significantly increased;it may play an important role in the occurrence and development of PAH in patients with HAPE.%目的 探讨缺氧诱导因子-1α(HIF-1α)和血管内皮生长因子(VEGF)与高原肺水肿患者肺动脉压的关系.方法 采用双抗体夹心酶联免疫吸附法(ELSIA)检测22例高原肺水肿(HAPE)患者治疗前及治愈后血清HIF-1α、VEGF含量、动脉血氧分压(PaO2),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),与30例当地健康人比较.结果 治疗前,HAPE组血清HIF-1α、VEGF、mPAP 显著高于健康对照组,(均P<0.01),PaO2显著低于健康对照组(均P<0.01).HAPE组血清HIF-1α、VEGF水平与mPAP均呈显著正相关(r＝0.826、0.831,均P<0.01),PaO2水平与mPAP呈显著负相关(r=-0.796,P<0.01).治疗后,HAPE组血清HIF-1α、VEGF和mPAP较治疗前显著降低(均P<0.01),PaO2显著升高(P<0.01),并与对照组比较差异无显著性(均P>0.05).结论 HAPE患者血清中HIF-1α、VEGF水平显著升高,其增高与HAPE患者PAH的形成有密切关系.