摘要
目的:探讨先天性心脏病患儿血清中的基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制物-1(TIMP-1)以及血管内皮生长因子(VEGF)表达水平及变化。方法:临床纳入左向右分流型先天性心脏病患儿81例,根据治疗前肺动脉收缩压(SPAP)的不同分为4组:非肺动脉高压(PH)组16例,轻度PH组21例,中度PH组21例,重度PH组23例。患儿中,接受前列腺素E1(PGE1)治疗19例,接受手术治疗24例。同时纳入21例同年龄段的健康体检儿童作为对照组。检测先天性心脏病患儿以及健康体检儿童的血清MMP-9、TIMP-1以及VEGF水平,同时计算MMP-9/TIMP-1比值。结果:先天性心脏病患儿VEGF水平均明显高于对照组,差异有统计学意义(P<0.05);在发生PH后,患儿MMP-9、TIMP-1均出现显著的升高(P<0.05);中度PH组MMP-9/TIMP-1明显上升(P<0.05);经过治疗,患儿MMP-9、TIMP-1以及VEGF水平均较治疗前有了明显降低(P<0.05)。结论:左向右分流型先天性心脏病合并PH患儿血清VEGF以及MMP-9可能协同参与了肺血管的重构;PGE1能够降低患儿VEGF、MMP-9以及TIMP-1的水平,这可能属于PGE1逆转肺血管重构的又一新发现;术后1周,先天性心脏病合并轻度PH、中度PH患儿VEGF、MMP-9以及TIMP-1水平出现显著的下降。
Objective：To investigate the serum level of matrix metalloproteinases-9（MMP-9）,tissue inhibitor of metalloproteinase-1（TIMP-1）and vascular endothelial growth factor（VEGF）of children with congenital heart disease.Methods：A total of 81 children with left to right shunt congenital heart disease were selected in our hospital.According to the pulmonary artery systolic pressure（SPAP）before treatment,they were divided into four groups：non pulmonary hypertension（PH）group of 16 cases,mild PH group of 21 cases,moderate PH group of 21 cases,severe PH group of 23 cases.A total of 19 cases had the prostaglandin E1（PGE1）treatment,24 cases of children had the surgery.At the same time,21 healthy children of the same age were selected as control group.Serum MMP-9,TIMP-1and VEGF of children with congenital heart disease and healthy children were detected and also the ratio of MMP-9/TIMP-1was calculated.Results：The levels of VEGF in children with congenital heart disease were significantly higher than the control group（P〈0.05）.MMP-9,TIMP-1of PH children were increased significantly（P〈0.05）;MMP-9/TIMP-1of moderate PH group were significantly increased（P〈0.05）;after treatment,MMP-9,children TIMP-1and VEGF levels were lower than before treatment（P〈0.05）.Conclusions：Serum VEGF and MMP-9of children with Left to right shunt congenital heart disease complicated with PH may be involved in the coordination of the pulmonary vascular remodeling.PGE1 can reduce VEGF,MMP-9and TIMP-1levels of the children,which may be a new discovery belongs to the pulmonary vascular remodeling reversal of PGE1.One week after operation,mild PH,moderate PH,VEGF,MMP-9and TIMP-1levels of children with congenital heart disease are decreased significantly.
出处
《海南医学院学报》
CAS
2015年第4期537-539,共3页
Journal of Hainan Medical University
基金
上海市科技创新计划(11213213772)~~
关键词
先天性心脏病
非肺动脉高压
基质金属蛋白酶-9
金属蛋白酶组织抑制物-1
血管内皮生长因子
Congenital heart disease
Non pulmonary arterial hypertension
Matrix metalloproteinases-9
Tissue in-hibitor of metalloproteinase-1
Vascular endothelial growth factor
