循環中のアニオテンシン変換酵素2濃度は,急性腎臓損傷と症における死亡率と関連しています
Ching-En Chen1,2, Ruey-Hsing Chou2,3,4,5, Jiun-Yu Guo3,6
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
PloS one
|August 29, 2025
まとめ
セプシス患者におけるアンジオテンシン変換酵素2 (ACE2) 濃度の上昇は,死亡率や急性腎臓損傷のリスクを予測する. 低ACE2濃度は生存率の改善と関連しており,重症治療における早期予後指標としてのACE2の可能性を示している.
科学分野:
- 集中治療薬
- 腎臓薬
- 生物化学
背景:
- 非古典的なレニン-アニオテンシン系 (RAS),特にアニオテンシン (1-7) / ACE2 / Mas軸は,重症な疾患において重要な役割を果たします.
- 血管新生変換酵素2 (ACE2) は心臓保護と抗炎症効果を示し,重症病院での治療の可能性を示唆しています.
研究 の 目的:
- 循環中のアニオテンシン変換酵素2 (ACE2) の濃度とセプシス患者の臨床結果との関連を調査する.
- セプシスの早期予後指標としてのACE2の可能性を評価する.
主な方法:
- 集中治療室 (ICU) に入院した414人のセプシス患者を対象とした単一センターの研究です.
- 患者はICUに入院後24時間以内に血清濃度に基づいて低 (<2.5ng/ mL) と高 (≥2.5ng/ mL) のACE2グループに分類された.
- 評価されたアウトカムには,急性腎損傷 (AKI),ICUでの死亡率,90日間の死亡率が含まれています.
主要な成果:
- ACE2値の上昇はSOFAスコア,総ビリルビン,乳酸,低血糖と相関していた.
- 高ACE2群はセプシスに関連したAKI (81. 6% vs. 69. 6%),腎置換治療を必要とするAKI (21. 3% vs. 11. 1%),ICU死亡率 (31. 9% vs. 17. 5%) および90日間の死亡率 (51. 7% vs.
- ACE2の上昇はICUでの死亡率の独立した予測因子であった (aOR2. 15,95%CI1. 04- 4. 41,p=0. 038).
結論:
- 循環中のACE2濃度の上昇は,セプシス患者におけるICU死亡率の独立した予測因子である.
- ACE2濃度の低下は生存率の向上と関連しており,重篤な疾患の早期予後生物マーカーとしての可能性を示唆しています.
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