原发性高血压患者血清抗α1受体和血管紧张素Ⅱ1受体自身抗体的临床观察

Increased autoantibody production against AT1-receptors and α1-adrenergic receptors in hypertensive patients

目的观察原发性高血压患者血清中抗血管紧张素Ⅱ受体1自身抗体（AT1受体抗体）、抗α1肾上腺素受体自身抗体（抗α1受体抗体）产生阳性率与患者性别、年龄、高血压家族史、高血压病程及是否合并其他心脑血管易患疾病史之间的关联性，从而探讨其产生的机制。方法采用酶联免疫吸附法（ELISA）对690例原发性高血压住院患者进行血清抗AT1、α1受体抗体检测。用logistic回归分析多因素与抗体阳性产生率间的关联性。结果抗AT1抗体和抗α1抗体阳性组其病程[分别为（9．3±11．0）年，（9．9±11．1）年]均明显长于抗体阴性组[分别为（7．3±9．3）年，（7．2±9．5）年，P〈0．01]，高血压家族史发生率AT1抗体阳性组显著高于阴性组（分别为47．69％，39．18％，P〈0．01）；多元logistic回归筛选与抗AT1抗体产生相关因素为性别、年龄、病程、家族史及是否伴糖尿病史，而与抗α1抗体阳性率相关的因素则为家族史、年龄和病程（P均〈0．05）。结论环境和遗传因素共同参与了抗AT1、α1受体自身抗体的产生。

Objective To observe autoantibodies production against AT1-receptors and α1-adrenergic receptors and association to risk factors, such as sex, age, family history, course of hypertension and other cardiovascular diseases in hypertensive patients. Methods A total of 690 patients with essential hypertension admitted to our hospital were selected and autoantibodies against AT1-receptors and α1- adrenergic receptors were detected by ELISA. Multiple logistic regression analysis was performed based on obtained data. Results Positive rates for antibody against AT1-receptors and α1-adrenergic receptors were 47. 1% （325/690） and 36.4% （251/690） respectively in this group of patients. Duration of hypertension history was significantly longer in the antibody against AT1-receptors and α1-adrenergic receptors positive groups [ （9.3 ± 11.0） year, （9. 9 ± 11.1 ） year ] compared to the negative groups [ （ 7. 3 ± 9. 3 ） year, （ 7. 2 ± 9.5）year,all P 〈 0.01 ]. The ratio of family history with hypertension was also significantly higher in antibody positive groups than negative ones （ 47. 69% vs 39.18% , P 〈 0.01 ） . Regression analysis demonstrated that 5 risk factors were related to positive production of autoantibody against AT1-receptors including female gender, age, family history, duration of hypertension history and diabetes. However, just age, family history, duration of hypertension history were main factors responsible to the production of autoantibody against α1-adrenergic receptors （ all P 〈 0.05 ）. Conclusion The environmental and genetic factors contributed to the autoantibody production in patients with essential hypertension.