Calabro S, Arcangeli G, Cisno F, Altinier G, Giuliano G
Istituto di Medicina del Lavoro, Università degli Studi di Firenze.
Med Lav. 1990 Jul-Aug;81(4):283-9.
In order to verify the value of the determination of serum angiotensin converting enzyme (ACEs) in the assessment of silicosis and silicotuberculosis, we studied 105 subjects: 61 suffering from silicosis, 12 from silicotuberculosis, 19 from tuberculosis and 13 from chronic obstructive pulmonary disease (COPD). The patients with silicosis and silicotuberculosis were classified into two categories on the basis of the radiological pattern of pneumoconiosis according to the ILO 1980 CLASSIFICATION: mild silicosis (from 1/1 to 2/1) and severe silicosis (from 2/2 to 3+ and/or conglomerate masses). ACEs values were higher in the subjects suffering from silicotuberculosis and silicosis; in the latter, however, we did not find any significant relation between ACEs values and the radiological pattern. The lowest values of ACEs were found in the COPD group. Our data showed a statistically significant difference between silicotic or silicotuberculotic patients and the COPD group (p less than 0.05). It can be supposed that COPD, which was also found in all subjects suffering from silicosis or silicotuberculosis, might have caused an underestimation of the observed ACEs values which, however, were higher than normal. This increase might have been caused by a numerical or functional enhancement of the macrophages, which produce ACE and play an important role in the pathogenesis of such diseases.
为了验证血清血管紧张素转换酶（ACEs）测定在矽肺和矽肺结核评估中的价值，我们研究了105名受试者：61名患有矽肺，12名患有矽肺结核，19名患有肺结核，13名患有慢性阻塞性肺疾病（COPD）。根据国际劳工组织1980年分类法，将矽肺和矽肺结核患者根据尘肺病的放射学模式分为两类：轻度矽肺（1/1至2/1）和重度矽肺（2/2至3+和/或结节状肿块）。患有矽肺结核和矽肺的受试者ACEs值较高；然而，在后者中，我们未发现ACEs值与放射学模式之间存在任何显著关系。COPD组的ACEs值最低。我们的数据显示矽肺或矽肺结核患者与COPD组之间存在统计学显著差异（p小于0.05）。可以推测，在所有患有矽肺或矽肺结核的受试者中也发现的COPD可能导致了所观察到的ACEs值被低估，然而这些值仍高于正常水平。这种升高可能是由产生ACE并在此类疾病发病机制中起重要作用的巨噬细胞数量或功能增强引起的。
