血管紧张素Ⅱ2型受体自身抗体与血压水平及肾功能的关系

Plasma Antibodies Against Angiotenin Ⅱ Type 2 Receptor and Inflammatory Markers with Blood Pressure and Renal Function

目的探讨血管紧张素Ⅱ2型受体自身抗体(抗 AT_2R)与血压水平及肾功能的关系。方法采用横断面研究方法,从门诊及体检人群中随机调查138例病人作为研究对象。根据血压水平按 JNC-7标准将其分为3组:正常血压组(≤120/80 mmHg,31例)、高血压前期组(120～139/80～89 mmHg,39例)、高血压组(≥140/90mmHg,68例)。通过问卷调查及体检获取一般资料,用酶联免疫吸附技术(ELISA)检测外周抗 AT_2R水平,放射免疫法检测肿瘤坏死因子α(TNF-α)及内皮素1(ET-1)水平,并检测血脂、血糖、肾功能等。结果①3组人群外周血抗 AT_2R 水平有明显差异(P<0.01),且随血压水平升高而降低;抗 AT_2R 水平与收缩压、舒张压、平均动脉压呈负相关(r=-0.900,P<0.01;r=-0.766,P<0.01;r=-0.666,P<0.01);②3组人群血尿酸、血肌酐水平有显著差别(P<0.05),抗 AT_2R 与其均呈负相关(r=-0.295,P<0.01;r=-0.361,P<0.05);③TNF-α、ET-1水平在3组间有差异显著(P<0.01),抗 AT_2R 与其均呈负相关(r=-0.791,P<0.01;r=-0.795,P<0.01)。④多元线性回归分析显示,年龄、TNF-α、ET-1及抗 AT_2R 是平均动脉压的独立影响因素(P 均<0.05);TNF-α、ET-1及抗AT_2R 是收缩压的独立影响因素(P 均<0.05);年龄、TNF-α、ET-1及抗 AT_2R 是舒张压的独立影响因素。结论抗 AT_2R 与血压水平呈明显负相关,并与外周血 TNF-α、ET-1水平变化有关;提示抗 AT_2R 可能在高血压及其相关肾功能损害过程中起一定作用。

Objective To investigate plasma antibodies against angiotenin Ⅱ type 2 receptor（ AT2 R） in a cohort of subjects with different BP level in relevant with inflammatory markers and kidney function. Methods One hundred and thirty-eight subjects were enrolled and classified into 3 groups according to JNC-7, with normal blood pressure （4120/80 mmHg, n=31 ）, prehypertension（ 130-- 139/85 --89 mmHg, n= 39 ） and hypertension（ ≥140/ 90 mmHg, n=68）. Plasma antibodies of AT2R were measured by ELISA, tumor-necrosis-factor-α（TNF-α） and endothelin 1 （ET-1 ） by radio-immunity, and biochemical indicator by automachine. Results 1） Plasma of antibodies against AT2R decreased with the increase of blood pressure, with significant intergroups differences（all P〈 0.01）. Correlation analysis revealed that antibodies against AT2R was negatively correlated with systolic blood pressure （SBP） and diastolic blood pressure （DBP）; 2）Blood uric acid and serum creatinine increased with the increase of blood pressure Call P〈0.01 ） ; both of them were negatively correlated with antibodies against AT2 R; 3） TNF-α and ET-1 increased with the increase of blood pressure with significant intergroups （all P〈0.01） which were negatively correlated with antibodies against AT2R; 4 ）Logistic regression analysis showed that age, TNF-α, ET-1 and plasma antibodies against AT2R were independent predictors for mean arterial blood pressure. Conclusion Plasma antibodies against AT2R is related to blood pressure and renal dysfunction, and were associated with plasma TNF-α and ET-1.