水肿型胰腺炎向坏死型胰腺炎进展中VEGF的表达及意义

目的：探讨在胰腺微循环障碍加重过程中血管内皮生长因子（VEGF）的表达及意义。方法：将大鼠随机分为假手术对照组（N组）、急性水肿型胰腺炎组（AEP组）及急性坏死型胰腺炎组（ANP组）。于建模后6、12和24h，分别采用ELISA法检测各组血清中的VEGF、TNF-α及淀粉酶（AMY）含量，免疫组织化学方法检测各组胰腺组织中VEGF蛋白的表达情况，并分析比较。结果：AEP组与ANP组胰腺组织中各时相点VEGF染色评分均明显高于N组（P〈0．05）；建模6hANP组的评分显著高于AEP组（P〈0．05），而12和24hANP组的评分均明显低于AEP组（P〈0．05）。ANP组和AEP组血清VEGF、TNF-α与AMY含量均显著高于N组（P〈O05）；ANP组与AEP组之间差异亦有统计学意义（P〈0．05），但AEP组建模24hVEGF含量和12hAMY含量与ANP组差异无统计学意义（P〉0．05）；血清VEGF与TNF-α（正相关（P〈O.05）。结论：VEGF作为相对独立的微循环影响因素与全身炎症反应呈正相关，但在胰腺微循环障碍持续加重期，胰腺组织及血管内皮细胞严重受损，VEGF表达减少，胰腺坏死病变难以逆转。

Expression and significance of VEGF in the conversion of edematous to necrotizing pancreatitis

Objective： To study the clinical significance of vascular endothelial growth factor （VEGF） expressions on pancreas microcirculation dysfunction exacerbation. Methods： Rats were randomized into sham group （N group）, acute edematous pancreatitis group （AEP group） and acutenecrotizing pancreatitis group （ANP group）. Six, twelve, twenty-four hours after model establishment, the contents of VEGF, TNF-α, AMY in serum and expression of VEGF protein immunohistochemistry in pancreatic tissue were determined by ELISA, and compared them with each other. Resultes： Compared with N group, the stain scores of pancreatic tissue in AEP group and ANP group were much higher（P〈0.05）. Compared with AEP group, the stain scores in ANP group was much higher after 6 h（P〈0.05）, but after 12 h and 24 h, it was much lower（P〈0.05）. Compared with N group, the contents of VEGF, TNF-α, AMY in serum in ANP group and AEP group were significantly higher（P〈0.05）, and there was a significant difference between ANP group and AEP group（P〈0.05）, while 24 h after model establishment, there was no significant difference（P〉0.05）. VEGF was positively correlated with TNF- α in serum（P〈0.05）. Conclusion： As a relatively independent factor of microcirculation, VEGF is positively correlated with systemic inflammatory response, but in pancreas microcirculation dysfunction exacerbation, pancreatic tissue and vascular endothelial cells are damaged, expression of VEGF is reduced, the pancreatic necrosis lesion can＇t be reversed.