Himeno W
Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
Kurume Med J. 2001;48(2):111-6. doi: 10.2739/kurumemedj.48.111.
Previous studies have demonstrated that the expression of angiogenic growth factors is induced in hypoxic models. However, little is known about these factors in patients with cyanotic heart disease. The purpose of this study was to examine the relationship between the plasma level of angiogenic growth factors and the severity of cyanosis. The study included 85 patients with cyanotic heart disease and age matched 81 controls. Median age was 4.2 years in the cyanotic group and 4.8 years in the control group. Mean systemic oxygen saturation was 80.6 +/- 7.3% in the cyanotic group and 98.1 +/- 0.5% in the control group. In the control group, vascular endothelial growth factor (VEGF) in the neonatal period was significantly elevated, then rapidly decreased within 3 months after birth. After 3 months of age, VEGF levels remained at a plateau. In contrast, this age dependency did not occur in hepatocyte growth factor (HGF) levels. Although VEGF and HGF levels were not different between the cyanotic and control groups within 3 months after birth, the VEGF level in the cyanotic group after 3 months of age was significantly elevated compared to the levels measured in the control group (149.2 +/- 105.6 vs. 66.3 +/- 22.5 pg/ml, p < 0.0001). Moreover, the VEGF level was negatively correlated with oxygen saturation (y = 440.6-3.53x, R = 0.47, p < 0.0001) in cases more than 3 months old. In contrast, no correlation was found between HGF level and oxygen saturation. Although physiologically increased VEGF in the neonatal period was rapidly decreased under normal oxygen saturation, a higher VEGF level persisted if systemic hypoxia was present. Persistently higher VEGF level may be related to the development of systemic to pulmonary collateral arteries in patients with cyanotic heart disease.
先前的研究表明，在缺氧模型中血管生成生长因子的表达会被诱导。然而，对于患有紫绀型心脏病的患者，人们对这些因子知之甚少。本研究的目的是探讨血管生成生长因子的血浆水平与紫绀严重程度之间的关系。该研究纳入了85例紫绀型心脏病患者，并与81名年龄匹配的对照者。紫绀组的中位年龄为4.2岁，对照组为4.8岁。紫绀组的平均体循环血氧饱和度为80.6±7.3%，对照组为98.1±0.5%。在对照组中，新生儿期血管内皮生长因子（VEGF）显著升高，然后在出生后3个月内迅速下降。3个月大之后，VEGF水平保持稳定。相比之下，肝细胞生长因子（HGF）水平不存在这种年龄依赖性。尽管出生后3个月内紫绀组和对照组的VEGF和HGF水平没有差异，但3个月大之后紫绀组的VEGF水平与对照组相比显著升高（149.2±105.6 vs. 66.3±22.5 pg/ml，p<0.0001）。此外，在3个月以上的病例中，VEGF水平与血氧饱和度呈负相关（y = 440.6 - 3.53x，R = 0.47，p<0.0001）。相比之下，未发现HGF水平与血氧饱和度之间存在相关性。尽管在正常血氧饱和度下新生儿期生理性升高的VEGF会迅速下降，但如果存在体循环缺氧，VEGF水平会持续较高。持续较高的VEGF水平可能与紫绀型心脏病患者体肺侧支动脉的形成有关。
