摘要
目的探讨2型糖尿病伴左心室扩大患者与血清抗β1和抗血管紧张素Ⅱ1受体（AT．）自身抗体的关系。方法选择171例2型糖尿病合并高血压患者（其中左心室扩大患者57例，左心室正常患者114例），106例糖尿病无高血压患者。以合成的β1和AT1受体多肽片段为抗原，应用酶联免疫吸附测定（ELISA）技术，检测上述患者血清中抗G-蛋白偶联型母1和AT。受体自身抗体。用超声心动图检查评价心脏结构和功能。用酶联免疫吸附法（ELISA）测定技术测定24h尿蛋白排泄率（UAER）。并运用多元logistic回归分析2型糖尿病患者左心室扩大的影响因素。结果糖尿病并高血压组抗β1和AT1受体抗体阳性率为45．0％（77／171）和46．2％（79／171），明显高于糖尿病无高血压组的16．0％（17／106）和10．4％（11／106），两组比较差异有统计学意义（P〈0．01）。糖尿病伴左心室扩大组抗β1和AT1受体抗体阳性率分别为61．4％（35／57）和64．9％（37／57），明显高于糖尿病心脏正常组的36．8％（42／114）和36．8％（42／114），两组比较差异有统计学意义（P〈0．01）。多元logistic回归分析显示4个与左心室扩大相关的危险因素，即病程、收缩压、β1和AT1受体抗体（P均〈0．05）。结论血清β1和AT1受体自身抗体与糖尿病并高血压左心室扩大有关，该抗体阳性可能对预测糖尿病合并高血压左心室扩大具有重要意义。
Objective To observe the positive rates of autoantibodies against β1 adrenergic receptors（β1-receptor） and angiotensin Ⅱ type 1 receptors （ AT1 -receptor） in type 2 diabetes patients with or without hypertension. Methods The epitopes of the second extracellular loop of β1-receptor （197-222） and AT1 receptor （ 165-191 ） were synthesized and serum autoantibodies were determined in type 2 diabetes patients with hypertension （ n = 171 ） or without hypertension （ n = 106 ）. Left ventricular dimension was determined by echocardiography. The 24-hour urinary protein was measured by ELISA. The risk factors for enlarged left ventricle were analyzed by multiple logistic regressions. Results The positive rates of the autoantibodies against β1-receptors （45.0%） and AT1-receptor （46. 2% ） in patients with type 2 diabetes with hypertension were significantly higher than those in patients with type 2 diabetes without hypertension （ 16. 0% and 10. 4% , respectively, all P 〈 0. 01 ） . In type 2 diabetes patients with hypertension and enlarged left ventricle, the positive rates of the autoantibodies against β1-receptor 61.4% （35/57）and against AT1-receptor 64. 9% （37/57）were significantly higher than those in type 2 diabetes patients with normal left ventricular dimension （ 36. 8% , 42/114 and 36. 8% , 42/114, respectively, all P 〈 0. 01 ）. Regression analysis demonstrated that course of disease, systolic pressure, serum autoantibodies against β1 adrenergic receptor and angiotensin Ⅱ type 1 receptors seraautoantibodies were independent risk factors for left ventricular enlargment （ all P 〈 0. 05 ）. Conclusion The serum β1 and AT1-receptor autoantibodies are related to enlarged left ventricle in type 2 diabetes patients with hypertension and suggest that autoantibodies against β1 and AT1 -receptor might play important roles in the pathogcnesis of type 2 diabetes patients with hypertension and enlarged left ventricle.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2010年第2期139-142,共4页
Chinese Journal of Cardiology
基金
湖北省自然科学基金资助项目（2002AB116）
关键词
糖尿病
2型
高血压
肥大
左心室
受体
肾上腺素能β1
受体
血管紧张素
Diabetes mellitus, type 2
Hypertension
Hypertrophy, left ventricular
Receptors, adrenergic, bata-1
Receptors, angiotensin
