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目的:分析不同病程脑动静脉畸形(AVM)血管中血管内皮生长因子(VEGF)和其受体的基因表达差异。方法:采用实时荧光定量RT-PCR,测定出血组11例(术前有出血表现)、无出血组12例(术前无出血表现)手术切除的AVM与正常对照组8例(正常颞浅动脉)标本的VEGF及其受体Flt-1、Flk-1/KDR基因表达水平。结果:出血组和无出血组VEGF基因表达水平均明显高于对照组(P<0.01),但该基因表达水平在出血组与无出血组之间无差异。FlK-1/KDR基因表达水平由高至低依次为出血组、无出血组和正常对照组,并且3组间差异有统计学意义(P<0.01)。然而,Flt-1基因在3组血管中表达水平差异无统计学意义(P>0.05)。结论:VEGF基因在人脑AVM血管中高表达,可能是脑AVM适应血流动力学状态而具有的血管重塑的特征性表现;AVM破裂出血可能与内皮细胞中VEGF和其受体Flk-1/KDR的高表达有关。
Objective: To analyze the gene expression difference of vascular endothelial growth factor (VEGF) and its receptor in cerebral arteries and veins malformations (AVM) in different course of disease. Methods: 11 cases of hemorrhage (bleeding before surgery) and 12 cases of non-hemorrhage (no bleeding before surgery) were detected by real-time fluorescence quantitative RT-PCR in 8 cases of normal and superficial arteries ) Specimens of VEGF and its receptor Flt-1, Flk-1 / KDR gene expression levels. Results: The expression of VEGF gene in hemorrhage group and non-hemorrhage group was significantly higher than that in control group (P <0.01). However, the expression level of VEGF gene was no difference between hemorrhage group and non-hemorrhage group. The levels of FlK-1 / KDR gene expression in descending order were hemorrhage group, no bleeding group and normal control group, and the difference between the three groups was statistically significant (P <0.01). However, there was no significant difference in the expression level of Flt-1 between the three groups (P> 0.05). Conclusions: The high expression of VEGF gene in human AVM blood vessels may be the characteristic manifestation of vascular remodeling that AVM can adapt to the hemodynamic status. The rupture of AVM may be associated with the expression of VEGF and its receptor Flk-1 / KDR high expression.