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首页> 外文会议>NATO Advanced Study Institute on Vascular Endothelium : Mechanisms of Cell Signaling >INCREASED MORTALITY IN CRITICALLY ILL PATIENTS WITH DECREASED PULMONARY CAPILLARY ENDOTHELIUM BOUND ANGIOTENSIN CONVERTING ENZYME ACTIVITY
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INCREASED MORTALITY IN CRITICALLY ILL PATIENTS WITH DECREASED PULMONARY CAPILLARY ENDOTHELIUM BOUND ANGIOTENSIN CONVERTING ENZYME ACTIVITY

机译：患有肺毛细血管内皮结合血管紧张素转化酶活性的肺毛细血管内皮素的患者增加了死亡率

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Pulmonary capillary endotheliun-bound (PCEB) angiotensin converting enzyme (ACE) activity was estimated in 29 mechanically ventilated critically-ill patients suffering from various pathological conditions associated with acute respiratory distress syndrome (ARDS) development, with lung injury score (LIS) ranging from 0 (no injury) to 3.7(ARDS). By means of indicator-dilution techniques we measured the single pass transpulmonary hydrolysis v = -In{l-M}(where M = metabolism) of the synthetic ACE substrate ~3H-benzoyl-Phe-Ala-Pro (BPAP), and calculated the modified kinetic parameter A_(max)/K_m, an index of functional capillary surface area (FCSA). Both v and A_(max)/K_m decreased with increasing LIS (r = -0.785, p<0.00l and r = -0.641, p<0.001, respectively), denoting a correlation between PCEB ACE activity depression and the clinical severity of acute lung injury (ALI). In our population, two distinct groups of A_(max)/K_m values, above and below the observed mean (3378 mL/min) may be formed: a high group of nine patients (5045 to 10149 mL/min) and a low group of twenty patients (385 to 3144 mL/min). Eight patients (8/9) in the high group survived, while only two (2/20) survived in the low group (p<0.001, Fisher's exact test). We conclude that high PCEB ACE activity expressed by the FCSA index A_(max)/K_m, a parameter depending on both enzyme mass available for reaction and enzyme fiinctional integrity, might distinguish survivors from nonsurvivors in critically-ill patients suffering from ALI/ARDS.
机译：肺炎毛细管内皮（PCEB）血管紧张素转换酶（ACE）活性估计在患有与急性呼吸窘迫综合征（ARDS）发育相关的各种病理条件的29例，肺损伤得分（LIS）范围0（无伤害）至3.7（ARDS）。通过指示剂 - 稀释技术，我们测量了合成αCE底物〜3H-苯甲酰基-ALA-Pro（BPAP）的单循环二玻璃水解v = -in {lm}（其中m =代谢），并计算改性动力学参数A_（MAX）/ K_M，功能性毛细管表面积（FCSA）索引。 v和a_（max）/ k_m都随着lis（r = -0.785，p <0.00l和r = -0.641，p <0.001），p <0.001，p <0.001），表示pceb ace活性抑郁和急性临床严重程度之间的相关性肺损伤（阿里）。在我们的群体中，可以形成观察到的平均值（3378ml / min的两个不同的A_（MAX）/ K_m值组：高九名患者（5045至10149ml / min）和低组织二十名患者（385至3144毫升/分钟）。高群中的八名患者（8/9）存活，而在低组中只存活了两（2/20）（P <0.001，Fisher的确切测试）。我们得出结论，由FCSA指数A_（MAX）/ K_M表示的高pCEB ACE活性，根据可用于反应和酶消除完整性的酶质量，这可能区分患有Ali / ARDS的患者患者的患者中的幸存者。

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