血浆血管紧张素Ⅱ 1型受体及其抗体与血压的关系

Relationship Between Angiotensin Ⅱ Type 1 Receptor/Autoantibodies in Plasma and Blood Pressure

背景血管紧张素Ⅱ1型受体(AT1R)与高血压的发生发展密切相关,且高血压患者外周血中已检出其自身抗体。目的探讨AT1R及其自身抗体(抗AT1R)与血压及炎性因子的关系。方法采用横断面研究方法 ,从体检人群中随机调查138例为研究对象,根据美国预防、检测、评估与治疗高血压全国联合委员会第7次报告(JNC7)将入选对象分为3组:正常血压组31例(≤120/80mmHg)、高血压前期组39例(120～139/80～89mmHg)、高血压组68例(≥140/90mmHg);用酶联免疫吸附技术(ELISA)检测血浆AT1R及抗AT1R水平,用放射免疫法检测肿瘤坏死因子α(TNF-α)、内皮素1;用自动生化分析仪检测血脂。结果血浆AT1R与抗AT1R水平随血压水平的升高而增加[AT1R:正常血压(3.63±1.41)比高血压前期(4.44±1.19)比高血压(5.45±0.85)μg/L;抗AT1R:正常血压(12.35±0.59)比高血压前期(25.86±1.17)比高血压(32.15±1.05)μg/L,分别为P<0.05,P<0.05,P<0.01];AT1R及抗AT1R与收缩压、舒张压、平均动脉压、TNF-α、内皮素1水平呈正相关;多元线性回归分析显示,AT1R及抗AT1R是收缩压、舒张压、平均动脉压的独立影响因素。结论血浆AT1R、抗AT1R表达水平随血压水平升高而有逐渐升高趋势,并与血压及炎性因子水平呈正相关,提示AT1R、抗AT1R在高血压发生发展中起重要作用。

Background Angiotensin Ⅱ type 1 receptor（AT1R）is closely related to hypertension,and new evidence has suggested that the autoantibodies to AT1R are present in the peripheral blood of hypertensive patients.Objective To investigate the relationship of AT1R and antibodies against angiotensin Ⅱ Type 1 receptor（AT1R-AA）with blood pressure and inflammatory factors.Methods One hundred and thirty-eight subjects were enrolled and divided into three groups according to JNC 7：normotensive（≤120/80 mm Hg,n=31）,pre-hypertensive（120-139/80-89 mm Hg,n=39）and hypertensive（≥140/90 mm Hg,n=68）groups.Plasma AT1R and AT1R-AA were detected by enzyme-linked immunosorbnent assay（ELISA）,tumor necrosis factor-α（TNF-α）and endothelin-1（ET-1）by radioimmunoassay,and blood fat by automatic biochemical analyzer.Results A positive correlation were demonstrated between AT1R/AT1R-AA and blood pressure levels [AT1R：normotensive（3.63±1.41）vs pre-hypertension（4.44±1.19）vs hypertension（5.45±0.85）μg/L;AT1R-AA：normotensive（12.35±0.59）vs pre-hypertension（25.86±1.17）vs hypertension（32.15±1.05）μg/L,P0.05,P0.05,and P0.01,respectively].Plasma AT1R/AT1R-AA were also positively correlated with systolic blood pressure,diastolic blood pressure,mean arterial pressure,TNF-α and ET-1.Multiple linear regression analysis showed that AT1R and AT1R-AA were independent predictors for systolic blood pressure,diastolic blood pressure,and mean arterial pressure.Conclusion Plasma AT1R/AT1R-AA levels tends to increased with blood pressure levels,and are positively correlated with blood pressure and inflammatory factors,which indicates AT1R/AT1R-AA play an important role in the development of hypertension.