Sandron D, Lecossier D, Grodet A, Basset G, Battesti J P
Ann Med Interne (Paris). 1984;135(1):46-50.
Two hundred ninety three patients with mediastinal and pulmonary sarcoidosis were assayed one or more than one time for seric angiotensin converting enzyme (SACE) using the method of Cushman and Cheung (substrate hippuryl-histidyl-leucin). Seventy one normal subjects and 163 patients with various broncho-pulmonary diseases excluding sarcoidosis were used as control. SACE is elevated in 67.2 p. 100 of the patients with sarcoidosis and reflects the intra and extrathoracic extend of the granuloma. Elevated levels of SACE in pneumoconiosis diminishes the diagnostic value of this test (as well as the presence of a normal SACE level in some sarcoid patients). There is no correlation between SACE and the percentage of lymphocytes in bronchoalveolar lavage fluid. SACE returns to normal in cases with spontaneous radiological improvement, and reaches more elevated levels in cases with worsening. An initial low level of SACE is usually a sign of a future good evolution. An initial high level is an argument for starting on steroid treatment. Repeated dosages of SACE are useful for monitoring the steroid posology at the end of the treatment and for deciding to stop it. Persistence of low levels allows to stop the treatment. Re-elevation of SACE may correspond to a radiological and clinical relapse or to an isolated and resolvent rebound.
对293例纵隔和肺部结节病患者采用库什曼和张的方法（底物为马尿酸酰 - 组氨酰 - 亮氨酸）对血清血管紧张素转换酶（SACE）进行了一次或多次检测。71名正常受试者和163例排除结节病的各种支气管肺部疾病患者作为对照。结节病患者中67.2%的SACE升高，且反映了肉芽肿在胸内和胸外的范围。尘肺病中SACE水平升高降低了该检测的诊断价值（以及一些结节病患者SACE水平正常的情况）。SACE与支气管肺泡灌洗液中淋巴细胞百分比之间无相关性。在放射学表现自发改善的病例中，SACE恢复正常，而在病情恶化的病例中达到更高水平。初始SACE水平低通常是预后良好的迹象。初始高水平是开始使用类固醇治疗的依据。重复检测SACE有助于在治疗结束时监测类固醇剂量，并决定是否停药。SACE水平持续低可停药。SACE再次升高可能对应放射学和临床复发或孤立的、可缓解的反弹。
