血管紧张肽转换酶与食管癌术后发生急性呼吸窘迫综合征的相关性研究

Relationship between the angiotensin -converting enzyme and acute respiratory distress syndrome after the operations of esophageal cancer

目的探讨血管紧张肽转换酶（ACE）与食管癌根治术后发生急性呼吸窘迫综合征（ARDS）的关系。方法选取食管癌根治术后发生ARDS的34例患者为研究对象，同期食管癌术后未发生ARDS的116例患者为对照，应用聚合酶链反应（PCR）方法检测ACE基因多态性，同时检测血清ACE水平（SACE）。结果与对照组相比，ARDS患者ACE基因型DD和等位基因D分布频率明显增高，差异有统计学意义（P〈0．05）；携带基因型Ⅱ的ARDS患者相比较于DD、ID患者机械通气时间和ICU住院时间最短，差异有统计学意义（P〈0．05）；ACE基因型、等位基因在ARDS存活组和病死组间的分布频率差异无统计学意义（P〉0．05）。ARDS患者血清ACE水平明显低于对照人群，差异有统计学意义（P〈0．05）。结论ACE基因多态性可能是决定食管癌术后ARDS发病的重要遗传信息，影响其预后，但可能对最终预后一病死率无明显影响。

Objective To study the relationship between angiotensin - converting enzyme （ACE）and acute respiratory distress syndrome （ ARDS ） after the operations of esophageal cancer. Methods Peripheral blood samples were collected from 34 ARDS patients and 116 non -ARDS patients after esophageal cancer operations. ACE genotype was determined by polymerase chain reaction, and the ACE of the serum was measured by ELISA method. Results Compared with control group, the DD genotype and the D allele in ACE genotype was markedly increased in the patients with ARDS （ both P 〈 0. 05 ）. Compared with ID/DD genotype, the II genotype associated with markedly shorter mechanical ventilation time and the days in ICU in the ARDS patients （ both P 〈0.05 } , but there was no statistically significant difference in ACE genotype and allele frequencies between the survival and the dead of ARDS patients （ P 〉 0.05 ）. Compared with control patients, the serum ACE （SACE） of the ARDS patients was decreased significantly { P 〈 0.05 ）. Conclusions ACE gene polymorphism may play an important role in the morbidity and progression of ARDS patients after esophageal cancer operation, but it may not be a determinant to influence the mortality.