心肌重构对抗β_1受体自身抗体及免疫功能的影响

Myocardium remodeling autoantibodies against β_1-receptors and clinical meaning of immune function

目的检测心肌重构患者血清中抗β1受体自身抗体和相关免疫指标的变化情况,探讨其变化特点、相互关系及临床意义。方法选择心室壁增厚、心腔与心壁比值增大、拟行手术的患者28例,正常人10例作为对照。应用链霉亲和素酶联免疫吸附测定技术(SAELISA),测定血清中抗β1受体自身抗体;应用流式细胞技术,测定CD3+、CD4+、CD8+含量及CD4+/CD8+比值,IgG、IgA、IgM及C3、C4含量。结果当心肌发生重构时,患者产生抗β1受体自身抗体,随着术后好转,该自身抗体也会随之降低。当抗β1受体自身抗体存在时,机体的细胞免疫CD4+/CD8+比值明显增高,体液免疫5项指标均有先下降后上升的趋势,与细胞免疫基本一致。结论心肌重构后,患者抗β1受体自身抗体的变化能反映术后疗效及心脏功能的恢复情况,可用来指导临床治疗。免疫功能的变化,说明心肌重构早期,机体免疫功能受到抑制,应注意围手术期采用综合性预防感染的措施。

Objective To study the change of special autoantibodies against β_1-receptors and some immune function target in myocardium remodeling patients.Detecting their changeable feature and analysing their relationships and clinical meaning.Methods Selecting 28 cases with myocardium remodeling and 10 health people as control.Applying Streptavidin-ELISA(SA-ELISA)to detect serum autoantibodies against β_1-receptors;applying fluid cell method(FCM)to set out CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+ ratio,and detecting IgG,IgA,IgM,C_3,C_4.Results After the myocardium remodeling,the patients produced autoantibodies against β_1-receptors.With recovery the antibodies reduced.While the autoantibodies against β_1-receptors existed,CD4^+/CD8^+ ratio rised obviously,five items of body fluid immune targets all had the trend of reducing then rising,it coincides with cell immune.Conclusion The autoantibodies against β_1-receptors is beneficial to estimate patient′s therapeutic effect and to prognose myocardium remodeling.It can guide clinical treatment.The immune function changing instructs that in the early period of myocardium remodeling the body immune function would be restrained.So we should pay attention to prevent infection around the operation period.