Abramov Y, Barak V, Nisman B, Schenker J G
Hebrew University Hadassah Medical Center, Ein Kerem, Jerusalem, Israel.
Fertil Steril. 1997 Feb;67(2):261-5. doi: 10.1016/S0015-0282(97)81908-5.
To assess the potential involvement of vascular endothelial growth factor in the hyperpermeability characterizing the ovarian hyperstimulation syndrome (OHSS).
A controlled clinical study that followed the kinetics of vascular endothelial growth factor in the plasma of patients with severe OHSS from the time of admission to the hospital and until clinical resolution.
Women hospitalized with severe OHSS in a tertiary medical center.
PATIENT(S): Seven patients with severe OHSS after ovulation induction for IVF and seven controls who had received a similar ovulation induction regimen and did not develop the OHSS.
INTERVENTION(S): Three blood samples were obtained from each OHSS patient: upon hospitalization for severe OHSS, when significant clinical improvement was evident, and on the first follow-up visit after the patients' discharge. Ascitic fluid was obtained from all OHSS patients by therapeutic paracentesis during the active phase of the syndrome. Blood samples were drawn from the control patients 4 to 6 days after ET. All samples were assayed for vascular endothelial growth factor levels, hematocrit, E2 levels, and white blood cell count.
MAIN OUTCOME MEASURE(S): Vascular endothelial growth factor levels were assayed by ELISA. Estradiol was determined by RIA.
RESULT(S): Compared with the controls, high levels of vascular endothelial growth factor were detected in the plasma of all patients admitted for severe OHSS. Levels dropped significantly along with clinical improvement, reaching minimum values after complete resolution. A statistically significant correlation was found between plasma vascular endothelial growth factor levels and certain biologic characteristics of OHSS and of capillary leakage such as leukocytosis and increased hematocrit. Ascitic fluid obtained from the study patients also contained high vascular endothelial growth factor levels.
CONCLUSION(S): These findings suggest the involvement of vascular endothelial growth factor in the pathogenesis of capillary leakage in the OHSS.
评估血管内皮生长因子在卵巢过度刺激综合征（OHSS）特征性高通透性中可能的作用。
一项对照临床研究，跟踪重度OHSS患者入院时直至临床缓解期间血浆中血管内皮生长因子的动力学变化。
一家三级医疗中心收治重度OHSS的女性患者。
7例因体外受精（IVF）诱导排卵后发生重度OHSS的患者以及7例接受相似排卵诱导方案但未发生OHSS的对照者。
从每位OHSS患者采集3份血样：重度OHSS住院时、临床明显改善时以及出院后的首次随访时。在综合征活动期，通过治疗性腹腔穿刺术从所有OHSS患者获取腹水。在胚胎移植（ET）后4至6天从对照患者采集血样。所有样本均检测血管内皮生长因子水平、血细胞比容、雌二醇（E2）水平和白细胞计数。
采用酶联免疫吸附测定法（ELISA）检测血管内皮生长因子水平。采用放射免疫分析法（RIA）测定雌二醇。
与对照组相比，所有因重度OHSS入院患者的血浆中均检测到高水平的血管内皮生长因子。随着临床改善，其水平显著下降，完全缓解后降至最低值。血浆血管内皮生长因子水平与OHSS及毛细血管渗漏的某些生物学特征（如白细胞增多和血细胞比容增加）之间存在统计学显著相关性。从研究患者获取的腹水中也含有高水平的血管内皮生长因子。
这些发现提示血管内皮生长因子参与了OHSS毛细血管渗漏的发病机制。
