【摘要】 目的 讨论ACE基因多态性及大容量肺灌洗术(WLL)对尘肺患者血清ACE浓度的影响。方法 对71例尘肺患者在全身麻醉下行WLL治疗，灌洗前后抽取静脉血， PCR方法检测ACE基因，酶两点终点法测定ACE浓度。结果 (1)71例尘肺病患者中，ACE基因Ⅱ型者35例，占49.3%，ID型者25例，占35.2%，DD型者11例，占15.5%；146例正常对照组中Ⅱ型者68例，占46.6%，ID型者54例，占37.2%，DD型者24例，占16.2%，两组基因型频率比较差异无显著性；(2)尘肺患者WLL前血清ACE浓度为43.5±13.37u/L,较对照组31.62±9.19 u/L明显增高(P<0.01)；(3) WLL后尘肺患者血清ACE浓度为26.74±8.71u/L，较术前明显下降，且趋于正常；(4)WLL前，ID基因型血清ACE浓度最高， DD型次之,II型最低。WLL后，DD基因型血清ACE浓度最高，ID型次之。 血清ACE浓度下降程度(△ACE)以ID型最明显，为14.28±10.66u/L,DD型次之，为9.45±6.43 u/L,II型变化最小，为 7.87±5.87 u/L(P<0.01)。结论 ACE基因多态性影响尘肺患者血清ACE浓度；WLL后患者血清ACE浓度明显下降。

    【关键词】 肺灌洗； 血管紧张素转换酶(ACE)； 基因多态性 ； ACE浓度

    The effects on serum ACE concentration in the Pneumoconiosis patients by ACE gene polymorphism and WLL

    MA Guo-xuan, LI Hong-fen, WU Shou-ling.

    Pneumoconiosis Rehabilitation Center of State Administration of Coal Mine Safety,Qinhuangdao 066104 ,China

    【Abstract】 Objective Analysis the effects on serum ACE concentration in the pneumoconiosis patients by ACE gene polymorphism and WLL .Methods 71patients were performed WLL under general anesthesia ;blood samples from the vein were taken before and after WLL; polymerize chain reaction was used to detected the ACE gene, the serum ACE was measured by the way of enzyme two points destination.Results (1) In the 71 pneumoconiosis group ,the frequency of ACE gene II, ID, DD genotype was 49.3%, 35.2%, 15.5% respectively. In the control group, the frequency of ACE gene II, ID, DD genotype was 46.6%, 37.2%, 16.2% respectively. There was no significant difference between each genotype of the two groups. (2) Serum ACE concentration in pneumoconiosis patients before WLL were higher than that of normal people. (3) The serum ACE concentration decreased dramatically after WLL and trend to normal. (4) Before WLL, ID geneotype serum ACE concentration was the highest,DD genotype was second,II genotype was the lowest; after WLL,DD genotype serum ACE concentration was the highest,ID genotype was the second; △ACE of ID geneotype is the largest, 14.28±10.66 u/L, DD geneotype is second, 9.45±6.43 u/L, II genotype was the lowest,7.87±5.87u/L(P<0.01).Conclusion Serum ACE concentration was affected by ACE gene polymorphism, and the serum ACE concentration decreased dramatically after WLL. ......