扩张型心肌病抗人心肌线粒体抗体的临床研究

THE CLINICAL STUDY OF AUTOANTIBODY AGAINST MITOCHONDRIA OF HUMAN MYOCARDIUM IN DILATED CARDIOMYOPATHY

目的 :检测扩张型心肌病 (DCM )患者血清中是否有抗人心肌线粒体抗体存在及其意义。方法 :以人心肌线粒体作抗原 ,应用免疫点印迹 (Immuno -dotblot)对 2 4例DCM、2 0例健康献血者 (HBD)进行抗人心肌线粒体抗体检测 ,用Westernblot方法检测其抗原分子量。结果 :10例 (41 7% )DCM患者抗人心肌线粒体抗体阳性 ,而HBD组 0 % ;早期患者阳性率(70 % )明显高于晚期患者 (2 1 4% ) (P <0 0 5 ) ;DCM抗体阳性与阴性患者之间心功能指标 (左室射血分数、左室舒张末期内径、心胸比例 )无明显差异 (P >0 0 5 ) ;人心肌线粒体特异性抗原的分子量为 3 0KD。结论 :①在DCM患者血清中存在抗人心肌线粒体抗体 ,支持DCM与自身免疫有关 ,对该抗体的检测可作为DCM的辅助诊断手段之一 ;②该抗体是DCM患者的早期指标 ,随着病程的进展 ,逐渐消失 ;③DCM抗人心肌线粒体抗体的检出率与心功能无明显关系 ;④该抗体的特异性抗原可能为人心肌线粒体腺苷酸转位酶。

Objectives:To evaluate the existence and significance of autoantibody against mitochondria of human myocardium in sera of patients with dilated cardiomyopathy(DCM).Methods:The human myocardium mitochondria was used as antigen to detect the autoantibody of sera from 24 DCM patients,20 HBD (healthy blood donors) with Immuno-dot blot. The antigenic molecular weight which was againsted by the autoantibody was evaluated by Western blot.Results:(a) By Immuno-dot blot,41.7% (10) sera from DCM showed autoautibodies against mitochondria of human myocardium, but,0 from HBD.(b) The positive rate (70%) of autoantibody in the early stage of patients with DCM was much higher than that(21.4%) in the late stage of patients with DCM (P<0.05).(c) There were no differences between autoantibody-positive and -negative DCM patients in any of the cardiac function parameters examined(left ventricular eection fraction, LVEF,left ventricular end-diastolic dimension,LVEDd, and cardiothoracic ratio, CTR)(P>0.05).(d) The antigenic molecular weight of human myocardium was 30KD.Conclusions:The findings suggested that: (a) The existence of autoantibody against mitochondria of human mitochondria supported autoimmune involvement in the pathogensis of DCM,and it might provide one of the adjunct diagnostic tools.(b) The autoantibody against mitochondria of human myocardium was early marker of DCM patients and became undectable with disease progress.(c) The detective rate of autoantibody against mitochondria of human myocardium in sera of DCM patients had no related to the cardiac function.(d) The specific antigen of autoantibody might be human myocardium adenine nucleotide translocator.