慢性阻塞性肺疾病患者血清VEGF、bFGF水平与肺动脉高压的关系研究
|
摘要
目的研究慢性阻塞性肺疾病(COPD)患者血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平与肺动脉高压(PAH)的关系。方法选取2015年3月至2018年3月我院收治的COPD患者115例为研究对象,将其中70例并发PAH患者纳入观察组,将未发生PAH者45例纳入对照组A,另选择同期入院体检的肺功能正常者30例纳入对照组B;对比三组血清VEGF、bFGF、肺动脉收缩压(PASP),并比较不同COPD患者(急性期、缓解期、稳定期)、不同COPD并PAH患者(依据PASP升高程度分为轻度、中度、重度)的血清VEGF、bFGF水平及PASP,分析血清VEGF、bFGF水平与PASP的相关性。结果观察组血清VEGF、bFGF水平及PASP明显高于对照组A、对照组B,对照组A、对照组B上述指标比较差异也有统计学意义(P<0.05);COPD患者中,急性期血清VEGF、bFGF水平、PASP高于缓解期、稳定期(P<0.05),缓解期、稳定期血清VEGF、bFGF水平差异也有统计学意义(P<0.05);在COPD并PAH患者中,PASP重度升高者血清VEGF、bFGF水平低于PASP轻度、中度升高者(P<0.05);单纯COPD患者血清VEGF、bFGF水平与PASP呈正相关,而COPD并PAH患者血清VEGF、bFGF水平与PASP呈负相关(P<0.05)。。结论 COPD患者血清VEGF、bFGF水平与PAH存在密切关系,在COPD并PAH患者中,随PASP升高,VEGF、bFGF有下降趋势。
Objective To study the relationship between serum vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) levels and pulmonary arterial hypertension(PAH) in patients with chronic obstructive pulmonary disease(COPD). Methods 115 patients with COPD from March 2015 to March 2018 were selected as subjects. 70 patients with PAH were included in the observation group and 45 patients without PAH were included in the control group A. Another 30 patients with normal lung function were included in the control group B. Serum VEGF and bFGF levels and pulmonary arterial systolic pressure(PASP) were compared among the three groups, COPD patients at different stages(acute stage, remission stage, stable stage) and COPD patients complicated with PAH(mild, moderate and severe). The correlation between serum VEGF and bFGF levels and PASP was analyzed. Results The serum VEGF and bFGF levels and PASP in the observation group were significantly higher than those in the control group A and the control group B(P<0.05). In patients with COPD, serum VEGF and bFGF levels and PASP were higher at acute stage than at remission stage and stable stage(P<0.05). In COPD patients complicated with PAH, serum VEGF and bFGF levels were lower in the severe group than in the mild and moderate group(P<0.05). Serum VEGF and bFGF levels were positively correlated with PASP in patients with simple COPD, while the levels were negative correlated with PASP inpatients with COPD and PAH(P<0.05). Conclusion Serum VEGF and bFGF levels in patients with COPD are closely related to PAH. In patients with COPD and PAH, VEGF and bFGF decrease with the increase of PASP.
Objective To study the relationship between serum vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) levels and pulmonary arterial hypertension(PAH) in patients with chronic obstructive pulmonary disease(COPD). Methods 115 patients with COPD from March 2015 to March 2018 were selected as subjects. 70 patients with PAH were included in the observation group and 45 patients without PAH were included in the control group A. Another 30 patients with normal lung function were included in the control group B. Serum VEGF and bFGF levels and pulmonary arterial systolic pressure(PASP) were compared among the three groups, COPD patients at different stages(acute stage, remission stage, stable stage) and COPD patients complicated with PAH(mild, moderate and severe). The correlation between serum VEGF and bFGF levels and PASP was analyzed. Results The serum VEGF and bFGF levels and PASP in the observation group were significantly higher than those in the control group A and the control group B(P<0.05). In patients with COPD, serum VEGF and bFGF levels and PASP were higher at acute stage than at remission stage and stable stage(P<0.05). In COPD patients complicated with PAH, serum VEGF and bFGF levels were lower in the severe group than in the mild and moderate group(P<0.05). Serum VEGF and bFGF levels were positively correlated with PASP in patients with simple COPD, while the levels were negative correlated with PASP inpatients with COPD and PAH(P<0.05). Conclusion Serum VEGF and bFGF levels in patients with COPD are closely related to PAH. In patients with COPD and PAH, VEGF and bFGF decrease with the increase of PASP.
引文
[1] 周应恩,克尤木·阿不来提,张淑娟.中西医结合治疗COPD伴肺动脉高压疗效及对血管内皮功能的影响[J].现代中西医结合杂志,2017,26(25):2820-2822.
[2] CALCAIANU G,CANUET M,SCHULLER A,et al.Pulmonary arterial hypertension-specific drug therapy in COPD patients with severe pulmonary hypertension and mild-to-moderate airflow limitation[J].Respiration,2016,91(1):9-17.
[3] RUSZKOWSKA-CIASTEK B,SOKUP A,SOCHA M W,et al.A preliminary evaluation of VEGFA,VEGFR1 and VEGFR2 inpatients with well-controlled type 2 diabetes mellitus[J].J Zhejiang Univ Sci B,2014,15(6):575-581.
[4] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[S].中华内科杂志,2007,46(3):254-261.
[5] 慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2014年修订版)[S].国际呼吸杂志,2014,34(1):1-11.
[6] 庄雅娟,李云超,杨艳君,等.铺灸疗法联合陈夏六君子汤对合并肺动脉高压COPD患者运动耐量及血清VEGF、NT-proBNP、IL-8的影响[J].现代中西医结合杂志,2018,27(7):765-768.
[7] 刘勇进,张意仲,夏仁瑞,等.阿托伐他汀联合常规治疗方案对老年COPD合并肺动脉高压患者VEGF水平及肺功能的影响[J].实用药物与临床,2016,19(9):1108-1110.
[8] WEIR-MCCALL J R,STRUTHERS A D,LIPWORTH B J,et al.The role of pulmonary arterial stiffness in COPD[J].Respir Med,2015,109(11):1381-1390.
[9] ADIR Y,HARARI S.Pulmonary hypertension associated with chronic obstructive lung disease and idiopathic pulmonary fibrosis[J].Curr Opin Pulm Med,2014,20(5):414-420.
[10] SEEGER W,ADIR Y,BARBER?J A,et al.Pulmonary hypertension in chronic lung diseases[J].J Am Coll Cardiol,2013,62(S25):D109-D116.
[11] 刘茜,王喜春,甘丹,等.辛伐他汀对老年 COPD合并PAH患者VEGF水平及肺功能的影响[J].重庆医学,2015,44(6):761-762,765.
[12] 薛晓辉.VEGF和bFGF在增生性玻璃体视网膜病变患者玻璃体中的表达及意义[J].陕西医学杂志,2016,45(6):707-708,719.
[13] 王娜娜,孟自力,陈亮,等.慢性阻塞性肺疾病并发肺动脉高压血清标志物研究[J].临床肺科杂志,2016,21(6):1051-1055.
[14] 闫明宇,孙艳红,杨敬平.法舒地尔对大鼠低氧性肺动脉高压及肺组织中bFGFmRNA、VEGFmRNA表达的影响[J].中国临床医生,2014,42(4):33-36.
[15] 李小静,刘川川,刘辉琦,等.低氧对大鼠血清bFGF、VEGF的表达和肺动脉超微结构的影响[J].中国高原医学与生物学杂志,2017,38(3):164-170.
[16] 张嫚.不同海拔地区AECOPD患者治疗前后血清中bFGF的变化及意义[D].西宁:青海大学,2014.
[17] PINTO-PLATA V,CASANOVA C,M?LLEROVA H,et al.Inflammatory and repair serum biomarker pattern:association to clinical outcomes in COPD[J].Respir Res,2012,13:71.
[18] 闫明宇,杨敬平,赵永祥.低氧性肺动脉高压大鼠肺组织中bFGFmRNA及VEGFmRNA的表达与肺血管重构的关系[J].中国冶金工业医学杂志,2017,34(4):373-375.
[2] CALCAIANU G,CANUET M,SCHULLER A,et al.Pulmonary arterial hypertension-specific drug therapy in COPD patients with severe pulmonary hypertension and mild-to-moderate airflow limitation[J].Respiration,2016,91(1):9-17.
[3] RUSZKOWSKA-CIASTEK B,SOKUP A,SOCHA M W,et al.A preliminary evaluation of VEGFA,VEGFR1 and VEGFR2 inpatients with well-controlled type 2 diabetes mellitus[J].J Zhejiang Univ Sci B,2014,15(6):575-581.
[4] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[S].中华内科杂志,2007,46(3):254-261.
[5] 慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2014年修订版)[S].国际呼吸杂志,2014,34(1):1-11.
[6] 庄雅娟,李云超,杨艳君,等.铺灸疗法联合陈夏六君子汤对合并肺动脉高压COPD患者运动耐量及血清VEGF、NT-proBNP、IL-8的影响[J].现代中西医结合杂志,2018,27(7):765-768.
[7] 刘勇进,张意仲,夏仁瑞,等.阿托伐他汀联合常规治疗方案对老年COPD合并肺动脉高压患者VEGF水平及肺功能的影响[J].实用药物与临床,2016,19(9):1108-1110.
[8] WEIR-MCCALL J R,STRUTHERS A D,LIPWORTH B J,et al.The role of pulmonary arterial stiffness in COPD[J].Respir Med,2015,109(11):1381-1390.
[9] ADIR Y,HARARI S.Pulmonary hypertension associated with chronic obstructive lung disease and idiopathic pulmonary fibrosis[J].Curr Opin Pulm Med,2014,20(5):414-420.
[10] SEEGER W,ADIR Y,BARBER?J A,et al.Pulmonary hypertension in chronic lung diseases[J].J Am Coll Cardiol,2013,62(S25):D109-D116.
[11] 刘茜,王喜春,甘丹,等.辛伐他汀对老年 COPD合并PAH患者VEGF水平及肺功能的影响[J].重庆医学,2015,44(6):761-762,765.
[12] 薛晓辉.VEGF和bFGF在增生性玻璃体视网膜病变患者玻璃体中的表达及意义[J].陕西医学杂志,2016,45(6):707-708,719.
[13] 王娜娜,孟自力,陈亮,等.慢性阻塞性肺疾病并发肺动脉高压血清标志物研究[J].临床肺科杂志,2016,21(6):1051-1055.
[14] 闫明宇,孙艳红,杨敬平.法舒地尔对大鼠低氧性肺动脉高压及肺组织中bFGFmRNA、VEGFmRNA表达的影响[J].中国临床医生,2014,42(4):33-36.
[15] 李小静,刘川川,刘辉琦,等.低氧对大鼠血清bFGF、VEGF的表达和肺动脉超微结构的影响[J].中国高原医学与生物学杂志,2017,38(3):164-170.
[16] 张嫚.不同海拔地区AECOPD患者治疗前后血清中bFGF的变化及意义[D].西宁:青海大学,2014.
[17] PINTO-PLATA V,CASANOVA C,M?LLEROVA H,et al.Inflammatory and repair serum biomarker pattern:association to clinical outcomes in COPD[J].Respir Res,2012,13:71.
[18] 闫明宇,杨敬平,赵永祥.低氧性肺动脉高压大鼠肺组织中bFGFmRNA及VEGFmRNA的表达与肺血管重构的关系[J].中国冶金工业医学杂志,2017,34(4):373-375.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |