高血压合并慢性心衰血清抗α_1受体自身抗体的检测及临床意义  

Detection of autoantibodies against α_1 adrenoceptors in patients with hypertension combined with heart failure and its clinical significance

作　　者：王敬萍[1] 曾秋棠[1] 阎莉[2] 刘慧荣[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院心内科,武汉430022 [2]山西医科大学生理学教研室

出　　处：《山西医科大学学报》2009年第2期142-145,共4页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(30572084)

摘　　要：目的观察抗α1受体自身抗体对高血压合并慢性心力衰竭的影响。方法以合成的α1受体细胞外第二环肽段作为抗原,用ELISA法检测高血压合并心衰组(n=146)、单纯高血压组(n=253)以及对照组(n=188)血清中的抗α1受体自身抗体,并分析自身抗体的产生与心脏结构、功能变化及肾损害之间的关系。结果146例高血压合并心衰患者中,62例抗α1受体自身抗体阳性,阳性率(42.5%)高于对照组(10.6%,P<0.01)和单纯高血压组(34.4%,P<0.05)。在高血压合并心衰组中,抗α1受体自身抗体阳性患者的心脏结构、功能变化和肾功能损伤程度均明显重于自身抗体阴性患者(P<0.05);但在3种不同心功能分级的亚组中,抗α1受体自身抗体阳性率比较差异无统计学意义(P>0.05)。结论高血压合并心衰患者抗α受体自身抗体检出频率显著增高,可能参与了心衰发生发展过程中的心肌重构和肾功能损伤等病理改变。Objective To explore the effect of autoantibodies againstα1 adrenoceptors on hypertension combined with heart tailure. Methods The peptides from the second extracellular loop of α1 adrenoceptors were synthesized as the antigens. The serum autoantibodies were detected in 146 hypertensive patients with heart failure,253 patients with hypertension and 188 normotensives by ELISA. Results The positive rate of autoantibodies against α1 adrenoceptom in hypertensive patients with heart failure（42.5% ）was significantly higher than those in the normotensives（ 10.6% ,P 〈 0.01 ）and in hypertension patients （34.4% ,P 〈 0.05 ）. In hypertensive patients with heart failure, there was significant difference in the cardiac structure and function and renal function injury between autoantibodies positive group and negative group（ P 〈 0.05 ） , but the positive rate of the autoantibodies against α1 adrenoceptors showed no significant difference among the patients with cardiac function class Ⅱ-Ⅳ. Conclusion The resuhs indicate that these autoantibodies might be involved in the cardiac remodeling and renal function injury during the development of heart failure.

关 键 词：自身抗体 alpha1肾上腺素能受体 高血压 心力衰竭 

分 类 号：R446.62[医药卫生—诊断学]