Khan A H, Ghani F, Khan A, Khan M A, Khurshid M
Department of Pathology, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 1998 May;48(5):131-3.
This study was conducted to determine the role of Serum Angiotensin Converting Enzyme (SACE) as a marker in the differential diagnosis of pulmonary diseases and prognosis of sarcoidosis. A retrospective analysis of 113 medical records of patients at The Aga Khan University Hospital, with laboratory investigation for SACE was performed. Among 113 patients, 51 cases were found to have sarcoidosis, 44 of them had SACE levels greater than 52 IU/L (mean ACE 104.44). SACE levels were also found elevated in other clinical conditions like tuberculosis (mean 58.64 IU/L), but the enzyme level were less (p 0.04) than those found in sarcoidosis (mean (92.97 IU/L). SACE activity was found to be considerably lower in other chronic lung diseases such as, fibrosing alveolitis (mean 43.98 IU/L), interstitial lung disease (mean 42.11 IU/L) and chronic obstructive lung disease (mean 40.85 IU/L). Twenty patients of sarcoidosis, who received steroid treatment subsequently showed a decline in the SACE levels. SACE is a useful marker in differential diagnosis as 37.2% cases of sarcoidosis compared to only 9.09% of tuberculosis had SACE levels greater than 100 IU/L. In addition, our data also suggest that serum ACE is useful for the diagnosis as well as monitoring prognosis in sarcoidosis.
本研究旨在确定血清血管紧张素转换酶（SACE）作为肺部疾病鉴别诊断和结节病预后标志物的作用。对阿迦汗大学医院113例患者的病历进行回顾性分析，并对其SACE进行实验室检测。113例患者中，51例被诊断为结节病，其中44例SACE水平高于52 IU/L（平均ACE为104.44）。在其他临床疾病如结核病（平均58.64 IU/L）中也发现SACE水平升高，但该酶水平低于结节病（平均92.97 IU/L）（p<0.04）。在其他慢性肺部疾病如纤维化肺泡炎（平均43.98 IU/L）、间质性肺病（平均42.11 IU/L）和慢性阻塞性肺病（平均40.85 IU/L）中，SACE活性显著降低。20例接受类固醇治疗的结节病患者随后SACE水平下降。SACE是鉴别诊断的有用标志物，因为37.2%的结节病患者SACE水平高于100 IU/L，而结核病患者只有9.09%。此外，我们的数据还表明血清ACE对结节病的诊断和预后监测也很有用。
