Notch1和血管内皮生长因子在出血性颅内动静脉畸形患者中的表达

目的研究Notch1和血管内皮生长因子（VEGF）在出血性颅内动静脉畸形（AVM）中的作用。方法回顾分析温州医学院神经外科手术治疗的AVM患者,共35例,根据病史和影像学特点,将AVM患者分为出血性AVM组（简称出血组）27例、非出血性AVM组（简称非出血组）8例,应用免疫组化、荧光实时定量PCR分别检测两组畸形血管团内Notch1和VEGF的表达差异及相关性。结果①在出血组和非出血组中,Notch1和VEGF在畸形血管团内皮细胞均表达明显,但两组Notch1、VEGF表达阳性率比较,差异均无统计学意义。②出血组的Notch1 mRNA水平为1.9±1.7,高于非出血组的1.5±0.6;出血组的VEGF mRNA水平为4.2±3.0,高于非出血组的2.9＋2.7,但两组比较差异均无统计学意义。③经Spearman相关分析,颅内AVM的Notch1与VEGF的阳性细胞率（r=0.638,P〈0.05）及其mRNA水平（r==0.611,P〈0.05）均呈正相关。结论 Notch1、VEGF在出血性AVM和非出血性AVM中均表达升高;但在出血性AVM中无特异性,Notch1与VEGF可能协同参与颅内AVM的形成。

Expression of Notch1 and vascular endothelial growth factor in hemorrhage from intracranial arteriovenous malformations

Objective To investigate the roles of Notch1 and vascular endothelial growth factor(VEGF) in hemorrhage from intracranial arterovenous malformations(AVMs).Methods A total of 35 patients with intracranial AVM treated in the Department of Neurosurgery,Wenzhou Medical College were analyzed retrospectively.The patients with AVM were divided into either a hemorrhagic AVM group(hemorrhagic group;n=27) or a non-hemorrhagic AVM group(non-hemorrhagic group;n=8) according to their medical history and imaging features.The malformation nidi in both groups were detected by immunohistochemistry and real-time fluorescence quantitative RT-PCR respectively.Results ①The mesothelial cells of Notch1 and VEGF expressed significantly within the malformation nidi in the hemorrhagic group and the non-hemorrhagic group.There was no significant difference in the positive rate of Notch1 and VEGF between the 2 groups.②The Notch1 mRNA level in the hemorrhagic group was 1.9±1.7,and it was higher than 1.5±0.6 in non-hemorrhagic group.The VEGF mRNA level in the hemorrhagic group was 4.2±3.0,and it was higher than 2.9+2.7 in the non-hemorrhagic group.However,there was no statistically significant difference between the 2 groups.③Spearman correlation analysis showed that Notch1 of the intracranial AVMs had correlations with the positive cells rate of VEGF(r=0.638,P<0.05) and the mRNA level(r=0.611,P<0.05).Conclusion Notch1 and VEGF expressed both in hemorrhagic and non-hemorrhagic AVMs,however it has no specificity in the hemorrhagic AVMs.Notch1 and VEGF may be synergistically involved in the formation of intracranial AVM.