循环AngⅡ及Ang(1-7)在评价急性创伤患者病情严重程度中的作用  

ROLE OF SERUM ANGⅡ AND ANG(1-7) IN ASSESSING THE SEVERITY OF ACUTE TRAUMATIC PATIENTS

作　　者：季永彬 高景利[1] 李世超 李晓岚[1] 王建军 杨秀红 

机构地区：[1]华北理工大学附属开滦总医院ICU,河北省唐山市063000 [2]华北理工大学 [3]华北理工大学附属医院ICU [4]华北理工大学基础医学院生理教研室

出　　处：《中国煤炭工业医学杂志》2017年第2期109-113,共5页Chinese Journal of Coal Industry Medicine

基　　金：国家自然基金项目(编号:81372029)

摘　　要：目的探讨血清血管紧张素Ⅱ(AngⅡ)及血管紧张素(1-7)[Ang(1-7)]水平对急性创伤性患者病情严重程度的预警作用。方法选取就诊于华北理工大学附属开滦总医院和华北理工大学附属医院重症加强治疗病房(ICU)急性创伤性患者53例(观察组)及健康查体者47例(对照组)。采集观察组伤后第一、二、三、七、十四天血清及对照组查体当天的血清,采用酶联免疫吸附试验技术检测血清AngⅡ和Ang(1-7)水平。采用APACHEⅡ评分表评估患者伤后第一、二、三、七、十四天病情的严重程度。利用全自动生化分析仪测定血清常规生化指标。应用SPSS17.0对数据进行统计学分析。结果观察组血清AngⅡ水平高于对照组(P>0.05),血清Ang(1-7)水平显著高于对照组(P<0.05);随APACHEⅡ评分增加,AngII水平增高(P=0.05),Ang(1-7)水平降低(P>0.05),AngⅡ/Ang(1-7)水平比值显著增高(P<0.05);观察组随着住院时间的延长,病情的好转,APACHEⅡ评分逐渐降低(P<0.05),AngⅡ水平呈下降趋势(P>0.05),Ang(1-7)水平逐渐增高(P<0.05),AngⅡ/Ang(1-7)水平比值逐渐降低(P<0.05)。结论创伤性患者血清AngⅡ及Ang(1-7)水平出现失衡,动态观察二者变化对患者病情有一定的预警作用。Objective To observe the values of serum angiotensin（Ang）Ⅱ and Ang（1-7）concentration levels in evaluation of clinical conditions in patients with acute traumatic.Methods A total of 53 cases of acute traumatic patients（trial group）and47 cases of healthy volunteers（control group）from author＇s hospital were enrolled in this study.The serums of trial group were collected on the day of 1st,2nd,3rd,7th,14 th after admission and the serums of control group were collected on the first day of admission.The serum levels of AngⅡand Ang（1-7）were determined using commercial enzyme-linked immunoassay kits.The APACHE Ⅱ scale was used to assess the severity of the injury at the day of 1st,2nd,3rd,7th,14 th days after admission.The related serum biochemical indexes were determined by automatic biochemical analyzer.The data were analyzed by SPSS 17.0.Results The serum levels of AngⅡin the trail group was higher than those in the control group（P〈0.05）,and Ang（1-7）was significantly higher（P〈0.05）.The higher of the APACHE Ⅱscore,the higher of the AngⅡlevels（P=0.05）,the lower of Ang（1-7）levels（P〉0.05）and the higher of the ratio of AngⅡ/Ang（1-7）（P〈0.05）;with the hospitalization time prolonged and condition improved,APACHE Ⅱ score was gradually decreased（P〈0.05）,and the level of AngⅡ was also decreased（P〉0.05）;the level of Ang（1-7）was gradually increased（P〈0.05）,and the ratio of AngⅡ /Ang（1-7）was gradually decreased（P〈0.05）.Conclusion There is an imbalance between serum levels of AngⅡ and Ang（1-7）in patients with traumatic,thus,observation of their dynamic changes may be useful for indication of clinical severity of diseases.

关 键 词：血管紧张素Ⅱ 血管紧张素(1-7) 急性创伤性疾病 

分 类 号：R641[医药卫生—外科学]