循环中的血管激素转化酶2度与急性损伤和败血症死亡率有关
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
概括
在败血症患者中,血管激素转化酶2 (ACE2) 水平升高预示着死亡和急性损伤的风险较高. 较低的ACE2度与改善的生存率有关,这表明ACE2作为重症监护的早期预后指标.
科学领域:
- 危急护理医学
- 脏医学
- 生物化学
背景情况:
- 非经典的氨酸-血管素系统 (RAS),特别是血管素 (1-7) / ACE2 / Mas轴,在严重疾病中起着至关重要的作用.
- 血管素转化酶2 (ACE2) 已表现出心脏保护和抗炎作用,这表明它在重症监护环境中具有治疗潜力.
研究的目的:
- 研究血液中的血管激素转化酶2 (ACE2) 度与败血症患者的临床结果之间的关联.
- 评估ACE2作为败血症结果的早期预后指标的潜力.
主要方法:
- 一个单一中心的研究包括414名进入医疗重症监护室 (ICU) 的败血症患者.
- 根据ICU入院24小时内的血清度,患者被分为低ACE2 (<2.5 ng/ ml) 和高ACE2 (≥2.5 ng/ ml) 组.
- 评估结果包括急性损伤 (AKI),ICU死亡率和90天死亡率.
主要成果:
- 较高的ACE2水平与较高的SOFA分数,总 bilirubin 和乳酸以及较低的血红蛋白相关.
- 高ACE2组显示出与败血症相关的AKI风险增加 (81. 6% vs 69. 6%),需要置换治疗的AKI (21. 3% vs 11. 1%),ICU死亡率 (31. 9% vs 17. 5%) 和90天死亡率 (51. 7% vs 39. 6%).
- ACE2 的升高是ICU 死亡率的独立预测因子 (aOR 2.15,95% CI 1. 04- 4. 41,p=0. 038).
结论:
- 循环中ACE2度的升高是治疗性败血症患者急症室死亡率的独立预测指标.
- 较低的ACE2度与更好的生存率有关,这表明它可能是危急疾病的早期预后生物标志物.
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