老年慢性心力衰竭患者血清β1肾上腺素受体自身抗体与心室复极离散度的相关研究  

Relationship of autoantibodies against cardiac β1 adrenergic receptors with dispersion of ventricular repolarization in elderly patients with chronic heart failure

作　　者：东燕[1] 李春梅[1] 孙媛媛[1] 王传霞[1] 周南南[1] 赵勇[1] 王建春[1] 李晓东[1] 

机构地区：[1]山东大学附属省立医院老年心内科,山东省济南市250021

出　　处：《实用老年医学》2013年第7期591-593,597,共4页Practical Geriatrics

基　　金：山东省科技发展计划课题资助项目(2011GGH21845);山东医药卫生科技发展计划课题资助项目(2011HZ066)

摘　　要：目的研究老年慢性心力衰竭患者血清抗β1肾上腺素受体自身抗体与心室复极离散度的相关性。方法观察2006～2009年老年冠心病慢性心力衰竭患者58例,在强心、利尿治疗的同时,给予酒石酸美托洛尔治疗6月,检测治疗前后心脏超声、脑钠肽(BNP)、动态心电图和抗β1肾上腺素受体自身抗体阳性率的改变,同时检测治疗前后血压、心率、肝肾功能并进行比较。结果与治疗前相比,心力衰竭患者的基础心率和BNP下降,心脏射血分数(EF)升高,心脏功能得到改善;同时发现,酒石酸美托洛尔治疗后,血清中抗β1肾上腺素受体自身抗体的阳性率均明显下降(P<0.01),动态心电图检测QTc和QTd也明显下降(P<0.01);相关性分析表明,抗β1肾上腺素受体自身抗体阳性与QTd延长有关(P<0.01)。结论老年慢性心力衰竭患者中抗β1肾上腺素变体抗体阳性与QTd明显相关,应用酒石酸美托洛尔能有效降低β1肾上腺素受体自身抗体的滴度和QTd,从而有效预防室性心律失常的发生。Objective To investigate the relationship of autoantibodies against cardiac adrenergic receptors with dispersion of ventricular repolarization in elderly patients with chronic heart failure(CHF). Methods Fifty-eight patients with CHF received traditional treatment with digoxin,diuretic and Betaloc treatment. All the patients were followed up for six months and the changes of cardiac function were analyzed by echocardiography. QTc and QTd were measured by Holter and β1 adrenergic receptors autoantibody were measured by enzyme-linked immunosorbent assay (ELISA). Results After treatment, systolic blood pressure and the level of brain natriuretic peptide (BNP) were significantly decreased(P<0.05). The positive ratio of autoantibody against cardiac β1-adrenergic receptors was decreased significantly (P< 0.01). QTc and QTd were all decreased(P<0.05). Conclusions Betaloc could effectively decrease the level of the autoantibody against cardiac β1-adrenergic receptors and QTd in elderly patients with chronic heart failure, which shows that autoantibody against cardiac β1-adrenergic receptors is related with QTd.

关 键 词：慢性心力衰竭 肾上腺素受体 自身抗体 

分 类 号：R541.6[医药卫生—心血管疾病]