血管紧张素转化酶活性与乙型病毒性肝炎患者临床分型关系的研究

The relationship between serum angiotensin-converting enzyme and different clinical rob-types in patients with hepatitis B

目的探讨血清血管紧张素转化酶（ACE）与乙型病毒性肝炎不同临床分型的关系及临床意义。方法利用连续监测法对健康组60例、慢性病毒性乙型肝炎组43例、Child-Pugh A级组36例、Child-Pugh B级组34例、Child-Pugh C级组32例各样本进行ACE活性和胆碱酯酶（CHE）活性的测定，比较各组ACE和CHE值，判断肝细胞损伤程度与血清ACE的活性及ACE和CHE之间的关系。结果乙型病毒性肝炎不同临床分型血清中ACE活性变化的顺序由低到高为：健康组（23．47±6．03）μmol／L，慢性病毒性乙型肝炎组（51．79±8．58）μmol／L，乙肝后肝硬化中Child-Pugh A级组（60．57±6．40）μmol／L，Child-PughB级组（68．22±6．62）μmol／L，Child-PughC级组（77．30±8．30）μmol／L，各组肝病患者血清ACE活性都明显高于健康组（P〈0．01）。CHE活性〉4000 IU／L时，ACE活性为（34．71±9．43）μmol／L，CHE在2000N4000 IU／L时，ACE活性为（53．16±8．46）t．LmolfL，CHE在1000～2000 IU／L时，ACE活性为（67．67±9．52）μmol／L，CHE〈1000 IU／L时，ACE活性为（79．27±7．53）μmol／L，各组间比较，差异有统计学意义（均P〈0．01）。结论检测病毒性乙型肝炎不同临床分型中血清ACE的活性变化，对于判断肝细胞损伤程度有一定的临床意义。

Objective To discuss the angiotensin-converting enzyme （ACE） changes in different clinical sub-types of hepatitis B. Methods The fully automatic biochemical analyzer was used to detect ACE activity and to measure acetylcholine esterase activity （CHE） in samples from the different groups. Results Serum ACE activity among the different clinical sub-types was as follows： control group （23.47 ± 6.03 ）μmol/L; chronic viral hepatitis B （51.79 ± 8.58 ） μmol/L; liver cirrhosis Child-Pugh A （ 60.57 ± 6.4 ） μmol/L; liver cirrhosis Child-Pugh B （ 68.22 ± 6.62）μmol/L; liver cirrhosis Child-Pugh C （77.3 ± 8.3 ）μmol/L. Serum ACE activity in patients with virus hepatitis B was significantly higher than that in the control group （ P 〈 0.01 ）. When CHE was 〉 4000 IU/L, the activity of ACE was（34.71 ±9.43）μg/L. The differences between each group were all significant （P 〈0.01 ）. Conclusion Serum activity of ACE in clinical sub-types of hepatitis B had clinical significance for assessing the degree of liver cell injury.