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先天性心脏病患儿的血管生成生物标志物:可能的影响。

Angiogenic biomarkers in children with congenital heart disease: possible implications.

机构信息

Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, (71515), Egypt.

出版信息

Ital J Pediatr. 2010 Apr 20;36:32. doi: 10.1186/1824-7288-36-32.

Abstract

BACKGROUND

Vascular endothelial growth factor (VEGF), platelet derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) and leptin are known as potent angiogenic factors The objective of the study was to evaluate these angiogenic factors VEGF, PD-ECGF/TP and leptin in children with congenital heart disease (CHD) and the factors that lead to angiogenesis in such cases.

METHODS

Sixty CHD children were studied and divided into two groups (n=30); cyanotic-CHD (C-CHD) and acyanotic-CHD (A-CHD). Twenty five healthy children were included as controls.

RESULTS

Significantly higher serum levels of VEGF, PD-ECGF/TP activity and leptin were detected in patients with CHD, particularly in patients with C-CHD. CHD patients with SpO2<90%, pulmonary hypertension (PH), severe pulmonary stenosis (PS), detectable collaterals, cardiomegaly and/or heart failure showed significantly higher levels of these factors than those with higher SpO2 or those without these findings.

CONCLUSION

Hypoxia, PH and PS are important factors that lead to harmful angiogenesis. However, angiogenesis could be essential in some cases of CHD as coarctation of aorta to enhance renal perfusion. This may provide new ways for therapeutic strategies aiming at reducing or promoting angiogenesis in CHD to improve patient's outcome.

摘要

背景

血管内皮生长因子(VEGF)、血小板衍生内皮细胞生长因子/胸苷磷酸化酶(PD-ECGF/TP)和瘦素是已知的强效血管生成因子。本研究旨在评估这些血管生成因子 VEGF、PD-ECGF/TP 和瘦素在先天性心脏病(CHD)患儿中的水平,以及导致此类病例发生血管生成的因素。

方法

研究纳入 60 例 CHD 患儿,并将其分为两组(n=30):发绀型-CHD(C-CHD)和非发绀型-CHD(A-CHD)。同时纳入 25 名健康儿童作为对照组。

结果

CHD 患儿的血清 VEGF、PD-ECGF/TP 活性和瘦素水平显著升高,尤其是 C-CHD 患儿。SpO2<90%、肺动脉高压(PH)、严重肺动脉瓣狭窄(PS)、可检测到的侧支循环、心脏扩大和/或心力衰竭的 CHD 患儿的这些因子水平明显高于 SpO2 较高或无这些发现的患儿。

结论

缺氧、PH 和 PS 是导致有害血管生成的重要因素。然而,在某些 CHD 病例中,如主动脉缩窄以增强肾灌注,血管生成可能是必要的。这可能为旨在减少或促进 CHD 中血管生成以改善患者预后的治疗策略提供新的途径。

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