van der Flier Michiel, van Leeuwen Henk J, van Kessel Kok P, Kimpen Jan L, Hoepelman Andy I, Geelen Sibyl P
Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Shock. 2005 Jan;23(1):35-8. doi: 10.1097/01.shk.0000150728.91155.41.
Vascular endothelial growth factor (VEGF) is a potent vascular permeability factor. The development of capillary leak is common in septic patients, and several sepsis-associated mediators may induce VEGF production. The potential role of VEGF during sepsis has not been studied to date. The aim of the study was first to assess whether circulating VEGF levels increase during sepsis, and second, to examine whether plasma VEGF levels are associated with disease severity. VEGF levels were measured in serial plasma samples of 18 patients with severe sepsis and in 40 healthy controls. VEGF levels were correlated to clinical signs and symptoms. VEGF levels were significantly elevated in sepsis patients compared with healthy controls (134 vs. 55 pg/mL; P <0.001). Serum albumin levels used as an indirect measure of vascular leak were decreased in septic patients. Increased plasma VEGF levels at study entry were correlated to severity of multiple organ dysfunction during the course of disease (Pearson correlation coefficient r=0.75; P=0.001). Moreover, maximum VEGF levels in nonsurvivors were significantly higher than those in survivors (P=0.018). These data show that plasma VEGF levels are elevated during severe sepsis. Furthermore, our data indicate that plasma VEGF levels are associated with disease severity and mortality. Further study of the potential role of VEGF in the development of sepsis-associated capillary leak is indicated.
血管内皮生长因子（VEGF）是一种强效的血管通透性因子。毛细血管渗漏在脓毒症患者中很常见，几种与脓毒症相关的介质可能会诱导VEGF的产生。迄今为止，VEGF在脓毒症中的潜在作用尚未得到研究。本研究的目的首先是评估脓毒症期间循环VEGF水平是否升高，其次是检查血浆VEGF水平是否与疾病严重程度相关。对18例严重脓毒症患者和40例健康对照者的系列血浆样本进行了VEGF水平测定。VEGF水平与临床症状和体征相关。与健康对照者相比，脓毒症患者的VEGF水平显著升高（134 vs. 55 pg/mL；P<0.001）。作为血管渗漏间接指标的血清白蛋白水平在脓毒症患者中降低。研究开始时血浆VEGF水平升高与疾病过程中多器官功能障碍的严重程度相关（Pearson相关系数r = 0.75；P = 0.001）。此外，非存活者的最大VEGF水平显著高于存活者（P = 0.018）。这些数据表明，严重脓毒症期间血浆VEGF水平升高。此外，我们的数据表明血浆VEGF水平与疾病严重程度和死亡率相关。提示需要进一步研究VEGF在脓毒症相关毛细血管渗漏发生发展中的潜在作用。
