Guo Jianying, Yan Wenwen, Yang Yong, Wang Zhiyong, Tian Fengjun
From the Department of Critical Care Medicine (J.G., Z.W.), the Third Hospital of Hebei Medical University, Shijiazhuang, China; Department of Intensive Care Unit (W.Y.), the First Hospital of Baoding, Baoding, Hebei, China; Department of Severe Medicine (Y.Y.), Xingtai People's Hospital, Xingtai, Hebei, China; and Department of Respiratory (F.T.), the Third Hospital of Hebei Medical University, Shijiazhuang, China.
J Trauma Acute Care Surg. 2017 Apr;82(4):766-770. doi: 10.1097/TA.0000000000001373.
This clinical observation study aimed to investigate the relationship between the serum levels of vascular endothelial growth factor (VEGF) and its soluble receptors with the severity and the occurrence of late acute respiratory distress syndrome (ARDS) in early trauma.
Sixty patients with multiple injuries were divided into three groups according to the Injury Severity Score (ISS) and the serum levels of VEGF, soluble VEGF receptor 1 (sVEGFR1), and sVEGFR2, were measured. Ten healthy people were recruited as controls. The incidence of late ARDS was also monitored, and its relationship to the above measures analyzed.
VEGF was not associated with ISS (p > 0.05); sVEGFR1 was positively associated with ISS (r = 0.459, p < 0.0001); however, sVEGFR2 was negatively associated with ISS (r = 0.510, p < 0.0001). The serum VEGF levels between the ARDS group and the non-ARDS group showed no significant difference (p > 0.05). sVEGFR1 in the ARDS group was significantly higher than that in the non-ARDS group (p < 0.0001), and sVEGFR2 in the ARDS group was significantly lower than that in the non-ARDS group (p < 0.0001).
In conclusion, the increasing of sVEGFR1 and the decreasing of sVEGFR2 in early trauma might be closely related to the occurrence of late ARDS.
Prognostic study, level III.
本临床观察研究旨在探讨血清血管内皮生长因子（VEGF）及其可溶性受体水平与早期创伤后迟发性急性呼吸窘迫综合征（ARDS）的严重程度及发生情况之间的关系。
根据损伤严重程度评分（ISS）将60例多发伤患者分为三组，并检测其血清VEGF、可溶性VEGF受体1（sVEGFR1）和sVEGFR2水平。招募10名健康人作为对照。同时监测迟发性ARDS的发生率，并分析其与上述指标的关系。
VEGF与ISS无关（p>0.05）；sVEGFR1与ISS呈正相关（r = 0.459，p<0.0001）；然而，sVEGFR2与ISS呈负相关（r = 0.510，p<0.0001）。ARDS组与非ARDS组的血清VEGF水平无显著差异（p>0.05）。ARDS组的sVEGFR1显著高于非ARDS组（p<0.0001），ARDS组的sVEGFR2显著低于非ARDS组（p<0.0001）。
综上所述，早期创伤中sVEGFR1升高和sVEGFR2降低可能与迟发性ARDS的发生密切相关。
预后研究，III级。
