| Objectives To investigate the correlation of changes of serum angiotensin?(Ang?),Ang(1-7),angiotensin converting enzyme(AC E)and ACE2 in RAS system in patients' condition with traumatic shock.Methods We consecutively enrolled 53 of acute trauma shock patients(as the case group)in intensive care unit(ICU)of Kailuan General Hospital and North C hina University of Science and Technology Affiliated Hospital,and chosen 47 healthy people as the control group in North China University of Science and Technology Affiliated Hosp ital from March 2015 to June 2016.General clinical data and routine serum biochemical indices were collected.Serum samples were collected from the control group and the case group at the 1st,3rd,7th day after injury.Serum concentrations of Ang?,Ang(1-7),ACE and ACE2 in RAS were measured by ELISA.The APACHE?score was used to assess the severity of the condition at the 1st,3rd and7 th day after injury.Serum biochemical indices were measured by automatic biochemical analyzer,including high sensitivity C-reactive protein(hs-CRP,reflecting systemic inflammatory response),albumin(reflecting severity of reactive trauma),cholinesterase(reflecting severity of reactive trauma)and so on.SPSS17.0 was used to analyze the data.Results 1 All of 53 cases of traumatic patients were collected including 46 cases of males,aged(45.80 ± 17.78)years old,and 7 cases of female,aged(55.86 ± 27.46)years old.According to the sites of trauma,there were 36 cases(67.92%)of chest,31 cases(58.49%)of limbs and pelvis,31 cases(58.49%)of face,30 cases(56.60%)of head and neck,28 cases(52.83%)of abdominal and pelvic.47 cases of the control group included 19 males with average age(55.63 ± 8.25 years)and 28 females with average age(59.14 ± 5.77)years.2 Serum Ang?level in the case group was higher than that in the control group,but there was no signficant difference(P>0.05).The level of serum Ang(1-7)was significantly lower than that of the control group(P<0.05).The level of serum Ang?/Ang(1-7)was significantly higher than that of the control group(P<0.05).3 The levels of serum AC E and ACE2 were significantly higher than those of the control group(P<0.05).The level of serum AC E/ACE2 was significantly lower than that of the control group(P<0.05).4 Univariate analysis between indices of the case group and APAC HE?score showed that there was a linear relationship among Ang?,Ang(1-7),AC E2,ACE/AC E2 and the APACHE?score.With increased Ang,Ang?/Ang(1-7)and AC E2,the APAC HE?score was significantly higher(P<0.05).With decreased ACE/AC E2,the APACHE?score was significantly higher(P<0.05).5 Multivariate analysis between indices of the case group and the APACHE?score showed that there was a linear relationship between ACE2 and the APACHE?score.With increased ACE2,APACHE?score was significantly higher(P<0.05).6 There were 20 patients followed up for 7 days.The APAC HE?score gradually decreased at the 1st,3rd and 7th day after admission.It showed that patients' condition got better.Compared with the 1st day,the difference was significant,whereas there was no statistical difference in changes of Ang II,Ang(1-7),ACE and ACE2 levels during the follow up.Conclusions 1 The level of Ang II/Ang(1-7)increases,and Ang(1-7)decreases in patients with traumatic shock.2 The levels of AC E and AC E2 increase,and AC E/ACE2 decreases in patients with traumatic shock.3 There was a linear relationship between ACE2 and the APACHE?score.With increased AC E2,the APAC HE?score wassignificantly higher(P<0.05),and patients' condition got worse.4 The levels of Ang?,Ang(1-7),AC E and AC E2 don't change with the improvement of illness. |
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