慢性充血性心力衰竭患者外周血淋巴细胞β-受体密度的变化及不同β-受体阻滞剂对其影响  

The β-adrenergic receptor binding in lymphocytes of patients with congestive heart failure

作　　者：刘媛[1] 余细勇[1] 林秋雄[1] 单志新[1] 杨敏[1] 

机构地区：[1]广东省心血管病研究所,广州市510080

出　　处：《岭南心血管病杂志》2003年第5期308-311,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的　探讨慢性充血性心力衰竭患者外周血淋巴细胞β 肾上腺素受体密度的变化规律。 方法　采用密度梯度离心法分离 112例心衰患者及 4 1例正常人单个核细胞 (含 90 %淋巴细胞 ) ,制备淋巴细胞膜 ,进行受体结合分析 ,求得平衡解离常数Kd和最大结合量Bmax。受体密度以Bmax表示。结果　心衰组 β 受体密度较对照组明显下降 ( P <0 0 1)。心功能Ⅱ级患者 β 受体密度明显低于正常对照组(P <0 0 1) ,重度心衰心功能Ⅲ、Ⅳ级患者β 受体密度下调更明显 (P <0 0 1)。冠心病与扩张型心肌病两组之间Bmax无显著性差异 (P =0 99)。心衰患者中 ,美托洛尔治疗组 β 受体密度明显高于非 β 受体阻滞剂治疗组 ( P <0 0 5 ) ,卡维地洛治疗组β 受体密度与非 β 受体阻滞剂治疗组无显著性差异(P =0 4 0 )。结论　心衰时出现了外周血淋巴细胞β 受体密度下调的现象。心衰时外周血淋巴细胞 β 受体密度下调与病因无关 ,下调的幅度与心衰严重程度有关。应用美托洛尔能明显上调βObjective To examine the binding of β adrenergic receptor(β AR) in congestive heart failure(CHF) and its relation to cardiac function. Method Lymphocytes of 112 cases with CHF and 41 normal controls were isolated by the method of density gradient centrifugation using Ficoll Hypaque solution. The binding of β adrenergic receptor was measured in the membrane preparation of lymphocyte, using 3H GCP12177 as ligand, a selective β 1 adrenergic receptor agonist. Results Compared with control group, the β AR density(maximal binding volume, B max ) was significantly decreased in heart failure( P <0 01). There was a positive correlation between the β AR density and the cardiac function. The β AR density was no significant different in CHF patients with coronary artery disease and idiopathic dilated cardiomyopathy. The β AR density in CHF group treated with metoprolol was significantly higher than those without β blockers. Conclusion These data demonstrated that heart failure is acompanied by downregulation of β AR in lymphocytes. There is a positive correlation between the β AR density and cardiac function. The β AR density is related to the primary disease of CHF. Metoprolol can up regulate β AR of lymphocytes.

关 键 词：慢性充血性心力衰竭 外周血淋巴细胞 Β-肾上腺素受体 美托洛尔 β-受体密度 

分 类 号：R541.61[医药卫生—心血管疾病]