ACE、ACE2基因在急性主动脉夹层和冠心病患者中表达的差异性研究

Study of the difference of ACE/ACE2 gene in acute aortic dissection and coronary heart disease

目的:探索ACE、ACE2基因在急性主动脉夹层和冠心病患者中表达是否存在差异。方法:收集68例患者血液样本,其中急性主动脉夹层34例(含Stanford分型A、B型),冠心病21例,对照组13例;所有患者均于入院后第2天清晨空腹采静脉血2 m L送检血浆ACE浓度。上述患者实施手术时于术中取动脉壁组织用于mRNA检测;实施开胸手术并取得主动脉壁者主动脉夹层12例,冠心病16例。结果:主动脉夹层组ACE浓度为(17.9±7.9)U/L,冠心病组ACE浓度为(33.5±8.1)U/L,对照组ACE浓度为(38.4±4.8)U/L,有统计学意义(P<0.05)。ACE基因在主动脉夹层组中的表达为(0.226 5±0.378 3);冠心病组中的表达为(7.085 7±7.692 9),差异有统计学意义(P<0.05)。ACE2基因在主动脉夹层组中的表达为(0.766 2±0.858 6);冠心病组中的表达为(9.612 7±11.542 6),差异有统计学意义(P<0.05)。ACE/ACE2的比值在主动脉夹层组中的表达为(0.413 8±0.448 6);冠心病组中的表达为(0.811 1±0.256 3),差异有统计学意义(P<0.001)。结论:血浆ACE浓度,ACE和ACE2基因表达在急性主动脉夹层中显著降低,ACE和ACE2表达失衡可能参与主动脉夹层的发病。

Objective：Exploration of the difference of ACE/ACE2 gene in acute aortic dissection and coronary heart disease. Methods：68 patients’ blood sample has been collected,included 34 acute aortic dissection patients（Stanford A and Stanford B）,21 coronary heart disease patients,13 control group patients. All the patients’ venous blood were sampled for check the plasma concentra-tion of ACE in the second morning. All the patients were taked artery walls for mRNA detection during the operation. Included 12 aortic dissection patients and 16 coronary heart disease patients. Results：The concentration of ACE in aortic dissection group was（17. 9 ± 7. 9）U/L,in coronary heart disease group was（33. 5 ± 8. 1）U/L,in control group was（38. 4 ± 4. 8）U/L,The differences have statisti-cally significant（P〈0. 05）. The expression of ACE in aortic dissection group was 0. 227 ± 0. 378,in coronary heart disease group was 7. 086 ± 7. 693. The difference has statistically significant（P〈0. 05）. The expression of ACE2 in aortic dissection group was 0. 7662 ± 0. 8586,in coronary heart disease group was 7. 0857 ± 7. 6929,The difference has statistically significant（P〈0. 05）. The expression of ratio of ACE and ACE2 in aortic dissection group was 0. 414 ± 0. 449,in coronary heart disease group was 0. 8111 ± 0. 2563,The differ-ence has statistically significant（P〈0. 001）. Conclusion：The plasma ACE concentration and ACE/ACE2 gene expression in aortic dis-section was significantly decreased. The unbalance of ACE and ACE2 gene expression may be involved in the pathogenesis of aortic dis-section.