支气管哮喘和慢性阻塞性肺疾病患者诱导痰中血管内皮生长因子水平的变化及意义

目的 探讨血管内皮生长因子(VEGF)在支气管哮喘和慢性阻塞性肺疾病(COPD)发病中的作用.方法 分别选择缓解期支气管哮喘患者(哮喘组)30例、稳定期COPD患者(COPD组)28例和健康志愿者(健康对照组)24例进行肺功能测定和用诱导痰检查方法对痰进行炎性细胞分类计数,并用ELISA法测定诱导痰上清液中VEGF水平.结果 哮喘组诱导痰中嗜酸粒细胞数为0.9(0.4～1.4)×109/L,明显高于COPD组和健康对照组的0.1(0～0.2)×109/L、0.0(0～0.1)×109/L(P值均<0.05);COPD组诱导痰中中性粒细胞数为2.3(1.8～2.8)×109/L,明显高于哮喘组和健康对照组的1.1(0.2～1.9)×109/L、1.0(0.8-1.2)×109/L(P值均<0.05).哮喘组、COPD组和健康对照组诱导痰上清液中VEGF水平分别为(2.3±0.5)、(0.3 4±0.1)、(0.94±0.2)μg/L,三组问比较差异有统计学意义(P值均<0.05)哮喘组诱导痰上清液中VEGF水平与诱导痰中嗜酸粒细胞数呈正相关(γ=0.62,P<0.05),与第1秒用力呼气容积(FEV,)占预计值百分比呈负相关(γ=-0.56,P<0.05);COPD组诱导痰上清液中VEGF水平与FEV1占预计值百分比呈正相关(γ=0.43,P<0.05),与诱导痰中中性粒细胞数无相关性(γ=0.21,P>0.05)结论 支气管哮喘患者诱导痰上清液中VEGF表达上调,VEGF可能参与了支气管哮喘的气道炎性反应过程;COPD患者诱导痰上清液中VEGF表达下降,VEGF可能参与了COPD的发病过程.

Changes and significance of vascular endothelial growth factor in induced sputum of bronchial asthma and chronic obstructive pulmonary disease

Objective To investigate the role of vascular endothelial growth factor (VEGF)in the pathogenesis of bronchial asthma and chronic obstructive pulmonary disease (COPD). Methods Thirty patients with stable bronchial asthma (asthma group), 28 patients with stable COPD (COPD group), and 24 healthy subjects (control group) were studied. Lung function, inflammatory cell differentials in sputum and the level of VEGF in induced sputum were determined by induced sputum method and ELISA method respectively. Results The levels of eosinophils in induced sputum in asthma group were 0.9 (0.4-1.4) × 109/L, significantly higher than those in COPD greup0.1 (0-0.2)×109/L], and control group0.0(0-0.1) × 109/L] (P < 0.05). The levels of neutrophils in COPD group were 2.3 (1.8-2.8) × 109/L, significantly higher than those in asthma group 1.1 (0.2-1.9) × 109/L], and control group 1.0(0.8-1.2) × 109/L] (P < 0.05). The levels of VEGF in asthma group, COPD group and control group were (2.3 ± 0.5), (0.3 ± 0.1), (0.9 ± 0.2) μg/L, respectively, and significant difference was showed between each group (P < 0.05). The VEGF level in induced sputum was positively correlated with the number of eosinophils in induced sputum in asthma group (γ = 0.62,P < 0.05), and was negatively correlated with FEV<,1>% (γ =-0.56, P < 0.05). The VEGF level in induced sputum was positively correlated with FEV1% in COPD group (γ = 0.43, P < 0.05), and was not correlated with the number of neutrophils in induced sputum (γ = 0.21, P > 0.05). Conclusions The concentration of VEGF in induced sputum increases in patients with bronchial asthma. VEGF may take part in the airway inflammatory development of asthma. The concentration of VEGF in induced sputum decreases in patients with COPD. VEGF may take part in the incidence of COPD.