抗AT_1受体自身抗体与冠脉内支架术后再狭窄的关系  

Agonistic autoantibodies against the angiotensin AT_1 receptor increase in unstable angina patients after stent implantation

作　　者：盛丽[1] 田苗[1] 黄鹏[1] 李军[1] 张传焕[1] 李留东[1] SHENG Li TIAN Miao HUANG Peng LI Jun ZHANG Chuanhuan LI Liudong(Department of Cardiology, Yantai Yu-Huangding Hospital, Medical College of Oing Dao University, Yantai, Shandong, 264000, Chin)

机构地区：[1]青岛大学医学院附属毓璜顶医院心内科,山东烟台264000

出　　处：《临床心血管病杂志》2016年第11期1111-1114,共4页Journal of Clinical Cardiology

基　　金：中国医师协会阳光心血管研究基金(No.SCRFCMDA201107);烟台科技发展计划(No.2010148-7);山东省科技发展计划(No:2012GGA06096)

摘　　要：目的:探讨不稳定型心绞痛患者血清中是否存在抗血管紧张素Ⅱ1型受体自身抗体及其与冠状动脉(冠脉)支架内再狭窄的关系。方法:随机抽选95例不稳定型心绞痛患者和98例健康受试者,检测外周血清中的抗血管紧张素Ⅱ1型受体自身抗体、细胞因子以及该抗体对血管平滑肌细胞增殖和c-fos、c-jun基因表达的影响。结果:空白对照组、不稳定型心绞痛组及支架植入组的抗体阳性率分别为10.20%、35.79%和47.37%。抗体阳性组及阴性组间细胞因子的变化无统计学意义。体外试验中该自身抗体显示出激动剂样作用,可刺激血管平滑肌细胞增殖,上调c-fos及c-jun基因的表达。这些效应与血管紧张素Ⅱ类似,可部分被AT_1受体拮抗剂缬沙坦阻断。结论:不稳定型心绞痛患者血清中的自身抗体有类似于血管紧张素Ⅱ的效应,可能在冠脉支架术后支架内再狭窄的发病机制中发挥了重要作用。Objective：To explore the existence of AT1 RAb in the unstable angina patients and the possible effects of them on the in-stent restenosis of these patients.Method：Ninety-five unstable angina patients and ninety-eight healthy volunteers were enrolled.The serum of each patient was detected for the presence of AT1 RAb and inflammatory factors（IF）by ELISA.The effects on the vascular smooth muscle cell proliferation and c-fos and cjun expression were studied in vitro.Result：AT1 RAb were detected in 34/95 patients with unstable angina.The incidence was 10.20%in control group and rose to 47.37% after stent implantation.There were no significant differences of IF between the antibody-positive and negative group.In vitro,this autoantibody displayed agonistlike activity,shown as simulation of vascular smooth muscle cell proliferation and up-regulation of c-fos and c-jun expression.These effects were similar to that of angiotensin II and could be weakened partly by AT1-receptor blocker Valsartan.Conclusion：Our findings demonstrated that the autoantibody from unstable angina patients exhibited similar agonistic activity as angiotensin II and might play a role in the pathogenesis of in-stent restenosis in these patients.

关 键 词：1型血管紧张素Ⅱ受体 自身抗体 支架内再狭窄 血管平滑肌细胞 

分 类 号：R541.4[医药卫生—心血管疾病]