门脉高压症患者食管壁组织血管内皮生长因子的表达及其与门脉和脾脏血流动力学的关系
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The expression of vascular endothelial growth factor in esophagus of patients with portal hypertension and its relationship with the dynamics of portal vein and spleen
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    目的:探讨门脉高压症患者食管壁组织中血管内皮因子(VEGF)的表达及其与门脉和脾脏血流动力学之间的关系。方法:36例接受联合断流术的门脉高压症患者术前行多普勒超声检查,测量门静脉和脾静脉直径(D)及平均流速(V),计算流量(Q)。术中留取食管壁组织,并通过胃网膜右静脉属支穿刺测量自由门静脉压力。对食管壁组织行VEGF免疫组化并进行半定量分析。结果:食管壁组织VEGF的表达情况:0分(-)3例,1~4分(+)10例,5~8分(++)18例,9~12分(+++)5例,阳性表达率为91.7%,高表达比率为63.9%。食管壁组织VEGF高表达组门静脉内径(Dp)和流量(Qp)-脾静脉内径(Ds)和流量(Qs)明显高于低表达组(P < 0.01);食管壁组织VEGF高表达组的门静脉流速(Vp)明显低于低表达组(P < 0.01),但两组间脾静脉流速(Vs)差异不明显(P > 0.05)。食管壁组织VEGF高表达组的自由门静脉压力明显低于低表达组(P < 0.01)。结论:门脉高压症患者食管壁组织中VEGF呈高表达,VEGF的高表达与门脉和脾脏血流动力学指标以及门静脉压力有关。VEGF所介导的血管新生是内脏高动力循环形成因素之一。

    Abstract:

    Objective:To explore the expression of vascular endothelial growth factor(VEGF) in esophagus of patients with portal hypertension and its relationship with the dynamics of portal vein and spleen. Methods:Thirty-six patiens who were undergone selective devascularization were received Doppler ultrasound examination, and the diameter and mean flow rate of portal vein and splenic vein were mesured before operation, and the blood flow were calculated. The esophagus tissue was reserved and FPP(free portal hypertension) was measured by puncturing the right gastroepiploic vein during the operation. Immunohistochemistry was used to detect the expression of VEGF in esophagus tissues. Results:The ranking of VEGF expression in esophagus tissues:0(-)3 cases;1-4(+)10 cases;5-8(++)18 cases;9-12(+++)5cases. The positive rate was 91.7% and the high expression rate of VEGF in esophagus is 63.9%. The diameter and flow of portal vein and splenic vein of the VEGF high expression group is higher than those of the VEGF low expression group(P < 0.01). The velocity of portal vein of the VEGF high expression group is lower than that of the VEGF low expression group (P < 0.01),but there was no obviously significant in the velocity of splenic vein between two groups(P < 0.01). The free portal pression of the VEGF high expression group is obviously higher than that of the VEGF low expression group(P < 0.01). Conclusion:The expression of VEGF in esophagus tissues of portal hypertension patients was high, and its high expression was related to parameters of portal and splenic hemodynamics and free portal pression. VEGF-mediated angiogenesis was one of the factors that caused hyperperfusion of splanchnic circulation in portal hypertension patients.

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潘一明,黄 旭,曹亚娟,包善华,谢 敏.门脉高压症患者食管壁组织血管内皮生长因子的表达及其与门脉和脾脏血流动力学的关系[J].南京医科大学学报(自然科学版),2013,(3):352-355

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  • 收稿日期:2012-11-17
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  • 在线发布日期: 2013-06-04
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