血管紧张素转化酶2在新型冠状病毒感染及心脏损伤中的作用

The role of angiotensin converting enzyme 2 in the novel coronavirus infection and cardiac injury

2019-新型冠状病毒(2019-nCoV)感染以呼吸系统损害为主,但危重症患者较多出现心血管损害。血管紧张素转化酶2(ACE2)广泛存在于人体组织、细胞中,是2019-nCoV侵入人体的受体,也是裂解血管紧张素Ⅱ的蛋白酶。2019-nCoV感染人体后一方面直接损伤脏器,另一方面造成ACE2水平下降,血管紧张素Ⅱ增加,将加重原有的心血管疾病;ACE2水平下降还可能减弱压力感受器和化学感受器反射,破坏患者的心肺代偿反应,表现为病情急剧恶化。因此,阻断2019-nCoV和ACE2的结合,能够减少病毒的侵袭并维持ACE2的心肺保护作用,是治疗的突破点。

Respiratory system injury is the main clinical manifestation of the novel coronavirus(2019-nCoV)infection,but cardiovascular injury is common in critically ill patients with 2019-nCoV infection.Angiotensin converting enzyme(ACE)2 is widely distributed in human tissues and cells.It is a receptor for the pathogen 2019-nCoV and a protease that cleaves angiotensin II.2019-nCoV infection on one hand causes acute organ damage,on the other hand decreases ACE2 and thus increases angiotensin I levels,which will aggravate the chronic cardiovascular diseases.The decrease of ACE2 level may also weaken baroreceptor and chemorecep-tor reflex and destroy the patient’s compensatory response,showing a rapid deterioration of the disease.Therefore,blocking the combination of 2019-nCoV and ACE2 may reduce the invasion of coronavirus,maintain the cardiopulmonary protective effects of ACE2,and will be a focus of the treatment.