Sun Zhong-Yi, Xia Hong-Gang, Zhu De-Qing, Deng Li-Min, Zhu Peng-Zhi, Wang Dong-Bin
Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300210, P.R. China.
Exp Ther Med. 2017 Sep;14(3):2531-2535. doi: 10.3892/etm.2017.4825. Epub 2017 Jul 20.
We investigated the clinical significance of mechanical ventilation on ischemic-reperfusion injury caused by lung chest trauma as well as vascular endothelial growth factor (VEGF) expression levels in peripheral blood. Sixty-eight patients with severe chest trauma complicated with acute respiratory distress syndrome that were treated at our Tianjin Hospital from September 2013 to July 2016 were recruited. These patients were randomly and evenly divided into two groups, the research group and the control group. Thirty-four age and gender matched healthy people were selected as the normal group. Routine treatment was given to both the research and control groups, but mechanical ventilation was used in the research group. We detected pulmonary vascular resistance (PVR) and alveolar-arterial oxygen difference (AaDO) for patients in both groups before treatment, and after treatment for 1, 3, 6 and 12 h. We also tested PMN, superoxide dismutase (SOD), malondialdehyde (MDA), NO and Ang II value 30 min before and after treatment. We used the ELISA-test to detect VEGF expression levels in peripheral blood, followed by a statistical analysis. PVR levels of different time points in the research group were significantly lower than control group after treatment. The AaDO value of the control group is much smaller than research group (P<0.5) after treatment for 1, 3 or 6 h. PMN count difference and MDA level in the research group is significantly lower than the control group after treatment for 30 min, but SOD and NO levels are much higher. Ang II levels of the research group in left atrial blood is significantly lower than control group (P<0.05). By comparing the hospitalization times, we found that patients in the research group have a shorter duration in hospital than the control group; differences are statistically significant (P<0.05). Additionally, compared to control group, research group VEGF expression levels in peripheral blood are significantly lower (P<0.05). Therefore, mechanical ventilation can reduce the high VEGF expression levels in serum caused by ischemic-reperfusion and can be used for clinical application.
我们研究了机械通气对肺胸部创伤所致缺血再灌注损伤以及外周血血管内皮生长因子（VEGF）表达水平的临床意义。选取2013年9月至2016年7月在我院天津医院治疗的68例严重胸部创伤合并急性呼吸窘迫综合征患者。这些患者被随机平均分为两组，即研究组和对照组。选取34例年龄和性别匹配的健康人作为正常组。研究组和对照组均给予常规治疗，但研究组使用机械通气。我们在治疗前以及治疗后1、3、6和12小时检测两组患者的肺血管阻力（PVR）和肺泡 - 动脉血氧分压差（AaDO）。我们还在治疗前后30分钟检测PMN、超氧化物歧化酶（SOD）、丙二醛（MDA）、NO和Ang II值。我们使用酶联免疫吸附测定法检测外周血中VEGF表达水平，随后进行统计分析。治疗后研究组不同时间点的PVR水平显著低于对照组。治疗1、3或6小时后，对照组的AaDO值远小于研究组（P<0.5）。治疗30分钟后，研究组的PMN计数差异和MDA水平显著低于对照组，但SOD和NO水平则高得多。研究组左心房血中的Ang II水平显著低于对照组（P<0.05）。通过比较住院时间，我们发现研究组患者的住院时间比对照组短；差异具有统计学意义（P<0.05）。此外，与对照组相比，研究组外周血中VEGF表达水平显著降低（P<0.05）。因此，机械通气可降低缺血再灌注引起的血清中高VEGF表达水平，可用于临床应用。
