【摘要 】 目的 观察急性呼吸窘迫综合征(ARDS)患者的血管内皮细胞标记物改变。方法 ARDS临床患者13例，检测血中循环内皮细胞(CEC)、血浆颗粒膜蛋白-140(GMP-140)、内皮素(ET-1)和血管性假血友病因子(vWF)含量并与10例正常对照血标本测定值比较；另取ARDS患者尸检肺组织及正常对照肺组织各5例，以免疫组化方法检测肺组织vWF含量。结果 ARDS患者CEC计数、血浆GMP-140、ET-1、vWF含量与对照组相比，差异具有显著性(P<0.01)。其中，血浆GMP-140第1天高于对照组3.7倍，第2天达到4.5倍；ARDS患者尸检肺组织的vWF含量积分显著低于正常对照组(P<0.01)。结论 ARDS伴有严重的肺血管内皮细胞(PVEC)损伤及脱落，储存物质释放，合成分泌功能改变；血浆GMP-140早期升高、幅度较大，可能在ARDS早期监测和病情评估方面有重要价值。

    

LI Qi, QIAN Guisheng, CHEN Zhengtang

Institute of Respiratory Diseases, Xingqiao Hospital, Third Military Medical University, Chongqing, 400037

【Abstract 】 Objective Toexplore the changes of the markers of pulmonary vascular endothelial cell(PVEC) inpatients with ARDS. Methods The levels of plasma circulating endothelial cell(CEC),granule membrane protein-140(GMP-140), endothelin-1(ET-1) and von Willebrand factor (vWF)were determined respectively in 13cases of ARDS. The vWF on the surface of the PVEC werestained in 5cases of ARDS. Results Circulating CEC,GMP-140, ET-1 and vWF levels wereincreased significantly (P<0.01) but scores of vWF expression on the PVEC became weak(P<0.01) in ARDS samples. The level of plasma GMP-140 elevated dramatically in 2ndday(>4 times). Conclusions PVEC are severely impaired during ARDS.GMP-140 releasedfrom PVEC might be a satisfactory criteria for early surveillance and for evaluation ofprognosis of ARDS in clinical practice.

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