多臓器障害(MODS)症例における血管新生因子の経時的変化と予後についての検討

概要

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Multiple organ dysfunction syndrome (MODS) still has a poor prognosis and its mortality is high. We have considered the function of how vascular endothelial cells influence the pathophysiology and prognosis of MODS and hypothesized there are similar relationships between prognosis and angiogenesis after endothelial cell injuries. So we investegated the factors of vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) as induction factors of angiogenesis, and platelet factor 4 (PF-4) as a suppression factor. We studied the angiogenesis and endothelial cell injuries in 21 MODS patients. Since their admission to the intensive care unit, we have surveyed the blood concentrations of VEGF, PDGF, PF-4 and compared the survivors with the dead. Among 21 MODS, in 12 survivors the blood level of VEFG and PDGF elevated after their injuries, and PF-4 decreased; however, after the patients were cured VEGF and PDGF decreased whereas PF-4 increased. The other 9 patients died while VEGF, PDGF and PF-4 did not significantly change. Therefore, the induction and suppression of angiogenesis were controlled appropriately in the survivors but were not in the dead. We conclude that if there is appropriate angiogenesis, the prognosis will be good; but if angiogenesis is poor, the prognosis will be bad. We must recognize and include "vascular (endothelial cell)" as one of the organs of MODS.
東京女子医科大学の論文
1998-05-25