血管紧张素Ⅱ1型受体、α1和β1肾上腺素能受体自身抗体与甲状腺毒症性心脏病相关性分析  

Relationship of autoantibodies against angiotensin Ⅱ-1 receptor, α1- and β1-adrenergic receptors with thyrotoxicosis heart disease

作　　者：徐金玲[1] 赵林双[1] 王敏[2] 

机构地区：[1]广州军区武汉总医院内分泌科,430070 [2]华中科技大学同济医学院附属协和医院心血管病研究所

出　　处：《中华内分泌代谢杂志》2013年第9期774-778,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：湖北省重点攻关课题（2006AA301861-2）;武汉市科技局应用基础研究计划项目（2013060602010244）

摘　　要：目的探讨抗G-蛋白耦联型血管紧张素Ⅱ1型受体（AT1R）、α1肾上腺素能受体（α1R）和β1肾上腺素能受体（β1R）自身抗体是否与甲状腺毒症性心脏病（THD）发病相关。方法以细胞外第二环表位肽段的合成肽作为抗原，应用酶联免疫吸附技术检测277例受试者血清中AT1R、α1R和β1R自身抗体。237例甲状腺毒症（TT）患者分为治疗组（n=148）和恢复组（n=89）、或THD（n=46）和TT无心脏病组（n=191）。正常对照组40名。结果（1）TT组AT1R、α1R和β1R自身抗体阳性率分别为31．6％、27．8％和23．6％，明显高于正常对照组的12．5％、10．0％和7．5％（P〈0．05）；TT患者中弥漫性毒性甲状腺肿（GD）组3种受体自身抗体阳性率（36．3％、32．2％和28．1％）明显高于非GD组（19．7％、16．7％和12．1％，均P〈0．05）。（2）TT治疗组AT1R和α1R自身抗体阳性率（40．5％和33．1％）明显高于TT恢复组（16．9％和19．1％，均P〈0．05）。（3）THD组AT1R和α1R自身抗体阳性率（52．2％和43．5％）明显高于TT无心脏病组（26．7％和24．1％，均P〈0．05）．结论抗G-蛋白耦联型AT1R、α1R和β1R自身抗体可能与甲状腺毒症发病有关，且AT1R和α1R自身抗体在THD病理生理过程中发挥重要作用。Objective To explore the relationship of autoantibodies against G protein coupled angiotensin Ⅱ-1 receptor （ AT1R）, α1 -adrenergic and β1-adrenergie receptors （ α1 R and β1 R） with thyrotoxicosis heart disease （THD）. Methods The epitopes of the second extraeellular loop of AT, R （ 165-191 ）, α1R （ 192-218 ）, and β1R （197-222） were synthesized for screening autoantibodies from 277 participants by ELISA. 237 patients with thyrotoxieosis were subdivided into thyrotoxicosis treatment group （ n = 148 ） and thyrotoxieosis recovery group （ n = 89 ） , or into THD group （n = 46） and simple hyperthyroidism group （n = 191 ）. 40 healthy subjects were served as control group. Results （ 1 ） The positive rates of autoantibodies against AT, R, % R and β1R in thyrotoxicosis patients were higher than those in the control subjects （ 31.6% vs 12.5 % , 27.8 % vs 10.0% , and 23.6% vs 7.5 % , all P〈0.05 ）. The positive rates of the three autoantibodies in the patients with Graves＇ disease were higher compared with thyrotoxicosis caused by other reasons （36.3% vs 19.7%, 32.2% vs 16.7% , and 28.1% vs 12.1%, all P〈 0.05 ）. （2） In thyrotoxicosis treatment group, the positive rates of auteantibodies against AT1 R and α1R were higher than those in the hyperthyroidism recovery group （40.5 % vs 16.9% and 33.1% vs 19.1%, both P〈0.05 ）. （ 3 ） The incidence of autoantibodies against AT1 R and α1R in THD were significantly higher compared with simple hyperthyroidism （52.2% vs 26.7% and 43.5% vs 24.1%, both P〈0.05）. Conclusions Autoantibodies against AT1 R, α1R, and β1R may play important roles in the pathogenesis of hyperthyroidism, which may be involved in the progression of THD.

关 键 词：甲状腺毒症性心脏病 血管紧张素Ⅱ1型受体 Α1肾上腺素能受体 Β1肾上腺素能受体 自身抗体 

分 类 号：R541.85[医药卫生—心血管疾病]