血管紧张素转换酶2水平对食管癌切除术后肺炎的影响。
Impact of angiotensin-converting enzyme 2 levels on postoperative pneumonia after esophagectomy.
作者信息
Nomura Shinsuke, Tsujimoto Hironori, Aosasa Suefumi, Saitoh Daizoh, Hase Kazuo, Ono Satoshi, Yamamoto Junji, Ueno Hideki
机构信息
Department of Surgery, National Defense Medical College, Saitama, Japan.
Department of Surgery, National Defense Medical College, Saitama, Japan.
出版信息
J Surg Res. 2018 Apr;224:200-206. doi: 10.1016/j.jss.2017.12.023. Epub 2018 Jan 4.
BACKGROUND
Pulmonary complications after esophagectomy are often fatal. The prediction of postoperative pulmonary complications remains a challenge. Accumulating evidence demonstrates a physiological and pathological role for angiotensin-converting enzyme 2 (ACE2) in the respiratory system. The purpose of this study was to evaluate the predictive value of ACE2 levels for the development of postoperative pneumonia.
METHODS
To evaluate the association between serum ACE2 levels and pneumonia after esophagectomy, we retrospectively reviewed the medical records of 80 patients who underwent thoracoscopic esophagectomy for esophageal cancer from 2009 to 2014.
RESULTS
Nineteen patients (23.8%) developed pneumonia after esophagectomy. Patients with pneumonia had significantly higher levels of ACE2 from the preoperative day to postoperative day (POD) 3, white blood cell count (POD7), and C-reactive protein (POD3, POD5, and POD7) than patients without pneumonia. Patients with postoperative pneumonia had higher serum ACE2 levels on POD3 than patients without pneumonia.
CONCLUSIONS
The elevation of ACE2 levels on POD3 may predict the incidence of pneumonia.
背景
食管癌切除术后的肺部并发症往往是致命的。术后肺部并发症的预测仍然是一项挑战。越来越多的证据表明血管紧张素转换酶2（ACE2）在呼吸系统中具有生理和病理作用。本研究的目的是评估ACE2水平对术后肺炎发生的预测价值。
方法
为了评估血清ACE2水平与食管癌切除术后肺炎之间的关联，我们回顾性分析了2009年至2014年接受胸腔镜食管癌切除术的80例患者的病历。
结果
19例患者（23.8%）在食管癌切除术后发生肺炎。肺炎患者从术前至术后第3天（POD）的ACE2水平、白细胞计数（POD7）以及C反应蛋白（POD3、POD5和POD7）均显著高于无肺炎患者。术后肺炎患者在POD3时的血清ACE2水平高于无肺炎患者。
结论
POD3时ACE2水平升高可能预测肺炎的发生率。
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