[A clinical study of the serum vascular endothelial growth factor in patients with severe sepsis]

To examine the dynamic changes in serum vascular endothelial growth factor (VEGF) levels in patients with severe sepsis, and to investigate its relationship with acute physiology and chronic health evaluation II (APACHE II) score and some clinical parameters of patients.

Using prospective, randomly control study design, 29 patients with severe sepsis admitted to the intensive care unit (ICU) of the Second Hospital of Tianjin Medical University from July 2006 to October 2007 were enrolled for study. Platelet (PLT) count and albumin (Alb) levels on the 1st, 3rd, 7th day were determined, and APACHE II score was assessed. VEGF levels of severe sepsis patients and healthy control volunteers (31 cases) were measured by enzyme linked immunoabsorbent assay (ELISA). The patients were divided into two groups according to survival or death, and the differences between two groups were compared.

The VEGF level in the health control group was (78.77+/-8.15) ng/L. In 16 survivors, the VEGF levels gradually lowered along the course of the disease (F=40.32, P<0.01). There was no statistical difference between control group and survival group on the 7th day (P>0.05). Thirteen patients died, and their VEGF levels lowered on the 3rd day, but elevated again on the 7th day (F=29.61, P<0.01). The VEGF levels showed obvious positive correlation with APACHE II score (r=0.510, P=0.000), and negative correlation with PLT (r=-0.221, P=0.046), and no relation with Alb levels (r=-0.029, P=0.789).

The VEGF levels are elevated at onset in severe sepsis patients. The VEGF levels lowered along with the course of the disease in survival group, but it lowers inconspicuously in death group. VEGF levels can reflect the severity of sepsis in certain degree.