Lower-extremity edema associated with gene transfer of naked DNA encoding vascular endothelial growth factor
Lower-extremity edema associated with gene transfer of naked DNA encoding vascular endothelial growth factor
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DOI：
10.7326/0003-4819-132-11-200006060-00005
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发表时间：
2000-06-06
影响因子：
39.2
通讯作者：
Isner, JM
中科院分区：
文献类型：
--
作者：
Baumgartner, I;Rauh, G;Isner, JM
背景：血管内皮生长因子（VEGF）促进血管新生和血管通透性。VEGF可能导致人体组织水肿的程度尚未确定。目的：评估接受VEGF基因转移的患者下肢水肿的证据。设计：前瞻性连续病例系列。设置：医院门诊。患者：62例严重肢体缺血患者和28例跛行患者。干预：VECF DNA的基因转移。测量：结果：90例患者中有31例（34%）观察到下肢水肿。水肿在跛行患者中的发生率低于静息痛患者（P = 0.016）或缺血性溃疡患者（P < 0.001），静息痛患者中的发生率低于缺血性溃疡患者（P = 0.017）。治疗通常局限于口服利尿剂的一个简短的过程。结论：血管内皮生长因子可能会增强人体血管通透性。在本研究中使用的质粒DNA剂量下，下肢水肿对口服利尿剂治疗有反应，似乎与严重后遗症无关。
Background: Vascular endothelial growth factor (VEGF) promotes angiogenesis and vascular permeability. The extent to which VEGF may cause tissue edema in humans has not been established.Objective: To evaluate patients undergoing VEGF gene transfer for evidence of lower-extremity edema.Design: Prospective consecutive case series.Setting: Hospital outpatient clinic.Patients: 62 patients with critical limb ischemia and 28 patients with claudication.Intervention: Gene transfer of VECF DNA.Measurements: Semiquantitative analysis of lower-extremity edema.Results: Lower-extremity edema was observed in 31 of 90 (34%) patients. Edema was less common in patients with claudication than in those with pain at rest (P = 0.016) or ischemic ulcers (P < 0.001), and it was less common in patients with pain at rest than in those with ischemic ulcers (P = 0.017). Treatment was typically limited to a brief course of oral diuretics.Conclusions: Vascular endothelial growth factor may enhance vascular permeability in humans. At the doses of plasmid DNA used in this study, lower-extremity edema responded to oral diuretic therapy and did not seem to be associated with serious sequelae.