急性胰腺炎患者血ACE2变化的临床研究

Clinical studie in patients with acute serum ACE2 change

目的探讨血管紧张素转化酶2(ACE2)在急性胰腺炎疾病中的表达及其临床意义。方法选取2015年2月至2015年11月健康体检者30例及急性胰腺炎患者60例,分为正常对照组、急性中重度胰腺炎组[(M)SAP)组]和急性轻度胰腺炎组(MAP组),胰腺炎组按照《中国急性胰腺炎诊治指南》进行规范化治疗,采用酶联免疫吸附方法测量患者第1、3、7天的ACE2表达,分析(M)SAP组和MAP组ACE2水平与正常对照组、急性生理与慢性健康评分II(APACHEII)、改良的CT严重指数(MCTSI)、C反应蛋白、淀粉酶之间的关系。结果 AP组ACE2明显低于正常对照组,差异有统计学意义(P<0.05)。ACE2在(M)SAP组随时间变化呈逐步下降趋势,在MAP组中随时间变化早期下降后期成上升趋势,ACE2与APACHII评分呈弱线性相关,ACE2与CRP无线性相关性,ACE2与AMY呈弱线性相关。结论 ACE2在急性胰腺炎患者血清中明显下降,说明ACE2与急性胰腺炎的发生、发展有一定的关系,可能与其表达降低后舒张血管、提高氧供、调节血管损伤作用减弱有关。

Objective To discuss serum ACE2 in acute pancreatitis （ Acute pancreatitis, AP） disease and its clinical significance.Methods From February 2015 to November 2015,90 cases were divided into normal control group （30 healthy cases） and pancreatitis group （60cases） including severe acute pancreatitis group （ （Moderately） severe acute pancreatitis, （ M） SAP） and acute mild pancreatitis group （ mild acutepancreatitis, MAP）. The treatment of pancreatitis was according to the ＂ Guide to Chinese diagnosis and treatment of acute pancreatitis＂standardized treatment. Enzyme - linked immunosorbent assay （ Enzyme - Linked immunosorbent Assay, ELISA） method was used for measuringACE2 expression in the first, 3 ,7 days. Analysis the relationship between the levels of ACE2 （M） SAP and MAP groups and the normal controlgroup, and acute physiology and chronic health evaluation II （Acute Physiology and Chronic Health Evaluation, APACHEII） , modified CT severityindex （modified CT severity index, MCTSI） , C - reactive protein （C - Reactiveprotein, CRP） and amylase （amylase, AMY）. Results Thelevel of ACE2 in AP group was obviously lower than that of normal control group, the difference was statistically significant （ P 〈0. 05）. ACE2changing over time in the MSAP group showed a trend of decline gradually, in the MAP group with a decline trend in the early late and a risingtrend in the late period. ACE2 was weakly linear correlated with APACHII score, ACE2 has no linear correlation with CRP and was weakly linearcorrelated to the AMY. Conclusion ACE2 in patients with acute pancreatitis decreased obviously, which demonstrate that it is correlate with theoccurrence and development of acute pancreatitis. The mechanism may be that its expression reduced diastolic blood vessels, increase oxygen supplyand help regulate blood vessel damage reduced.