الفهرس 
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Abstract
Chronic obstructive pulmonary disease (COPD) is a growing cause of morbidity and mortality worldwide, and will be the third leading cause of death by 2020. COPD is defined as a preventable and treatable disease with significant extra pulmonary effects characterized by progressive airflow limitation that is not fully reversible and associated with an abnormal inflammatory response in the lungs to noxious particles or gases. VEGF levels measured in the peripheral circulation as a biomarker of neovascularization and/or vascular remodelling. Several studies have reported increased circulating VEGF levels in conditions in which tissue hypoxia and/or inflammation are critical(14), which are both relevant to COPD (15).
The aim of this study was to evaluate the diagnostic value of serum vascular endothelial growth factor in stable and acute exacerbations of chronic obstructive pulmonary disease.
This study was carried out on 75 persons; twenty five of them were non-smokers healthy volunteers included as a control group.
The others were 50 patients with COPD diagnosed and classified according to GOLD 2013.(31) These patients were classified into 2 groups:
group (B): twenty five stable COPD patients.
group (C): twenty five COPD patients in acute exacerbations
All persons in the present study underwent full history taking, complete clinical examination, routine laboratory investigations, chest X-ray (postero-anterior and lateral views). They also underwent pulmonary function tests. Blood sample was obtained from all persons for measurement of serum VEGF by ELISA.
In this study, the mean age of the patients was (54.7 ± 7.55 years), the mean age of the controls was (52.12 ± 4.9 years). There was no statistically significant difference between both groups regarding their age. (P > 0.05).
Also, there was no statistically significant difference between stable COPD patients and COPD patients in exacerbations regarding age (53.5 ± 6.9 and 55.9 ± 8.2 years) respectively.
There was a highly statistically significant difference between patients and controls regarding pulmonary function tests.
Body mass index showed insignificant difference in COPD patients in comparison with the control group.
Current results revealed that serum VEGF levels were significantly elevated in both AECOPD (698.6 ± 41.8 pg/ml) and stable COPD (444.5 ± 36.6 pg/ml) groups compared with the healthy controls (298.3 ± 38.2 pg/ml) with the highest levels in the AECOPD group.
An inverse correlation between serum VEGF and FEV1% of predicted in stable COPD patients was found.