摘要
目的探讨心肌抗β1肾上腺素能受体和M2胆碱能受体自身抗体在慢型克山病与扩张型心肌病中的变化和临床意义。方法以人心肌β1和M2受体细胞外第二环表位肽段作为抗原,应用酶联免疫吸附测定技术,检测32例慢型克山病患者、28例扩张型心肌病患者、31例健康对照者血清中抗心肌β1和M2受体自身抗体。结果慢型克山病和扩张型心肌病患者血清中抗心肌β1受体自身抗体阳性率分别为53．1％(17／32)、57．1％(16／28),组间比较差异无统计学意义(P>0．05),但二者均明显高于对照组(9．7％),与对照组比较差异有统计学意义(X2=13．72、X2=15．18,P<0．01);抗M2受体自身抗体阳性率分别为56．3％、64.3％,组间比较差异无统计学意义(P>0．05),但二者与对照组(12．9％)比较差异有统计学意义(X2=13．02、X2=16．16,P<0．01);慢型克山病抗心肌β1和M2受体自身抗体阳性率及抗体滴度只有在组内心功能Ⅱ-Ⅲ级与Ⅳ级间比较时,差异有统计学意义(X2=4．12、X2=4．50,P<0．05;t=2．38,P<0．05),扩张型心肌病也有统计学意义(X2=3．92、X2= 4．01,P<0．05;t=2．47,P<0．05);两组间同级心功能比较,差异无统计学意义(P>0．05)。结论慢型克山病和扩张型心肌病患者血清中抗心肌β1和M2受体的自身抗体阳性率及滴度明显升高,自身抗体阳性率及抗体滴度在不同分级心功能患者间有明显差别,但在两种疾病之间无差别。
Objective To explore the roles of serum autoantibodies against myocardial β1 adrenergic and M2 cholinergic receptors in the pathological process of chronic Keshan disease （CKD） and dilated cardiomyopathy （DCM）. Methods The second extracellular loops of β1 and M2 receptors on human cardiomyocytes were used as the antigens. Enzyme linked immunosorbent assay （ELISA） was applied to determine serum autoantibodies against myocardial β1 and M2 receptors in 32 CKD and 28 DCM patients,and 31 healthy controls. Results Positive rates of autoantibody against myocardial β1 adrenergic receptor in CKD （51.3%, 17/32） and DCM （57.1%, 16/28） were significantly higher than those in the control （9.7%,3/31;x^2 = 13.72,x^2 = 15.18,P 〈 0.01）, but no difference existed between CKD and DCM group （P 〉 0.05）. Comparatively, positive rates of autoantibody against myocardial M2 cholinergic receptor in the two groups being 56.3% （18/32） and 64.3% （18/28）, respectively, showed no significant difference （P 〉 0.05）,but were significantly higher than that in the controls （ 12.9%, 4/31 ; x^2 = 13.02,x^2 = 16. 16, P 〈 0.01）. Positive rates and titers of the two autoantibodies were almost similar （P 〉 0.05） in the same class Ⅱ - Ⅲ and Ⅳ of cardiac function in CKD and DCM group,whereas a significant difference was indicated in the different class of cardiac function within each groups （x^2 = 4.12, x^2 = 4.50,P 〈 0.05;x^2 = 3.92,x^2 = 4.01 ,P 〈 0.05 ;t = 2.38, t = 2.47,P 〈 0.05）. Conclusions Positive rates and titers of autoantibodies against myocardial β1 and M2 receptors in sera of CKD and DCM patients are significantly higher than those in the controls ; distribution of positive rates and titers of the autoantibodies in various NYHA classes of cardiac functionate significantly different within each group, but not significantly between the two groups.
出处
《中国地方病学杂志》
CAS
CSCD
北大核心
2006年第4期440-443,共4页
Chinese Jouranl of Endemiology
基金
陕西省科技攻关基金资助项目(2000K14-G14)
