子痫前期患者血清中血管紧张素Ⅱ1型受体自身抗体的检测及其免疫学特征分析

Screening of Serum Autoantibody against AT1 Receptor in Preeclamptic Patients

目的研究AT1-AA在子痫前期患者血清中的分布规律并分析该抗体与子痫前期患者典型体征的关系。方法检测对象:子痈前期患者82例,未孕健康妇女48例。间接SA—ELISA(Streptavidin.ELISA)方法测定血清自身抗体。结果判定:以P/N≥2.1为阳性,P/N≤1.5为阴性,将血清标本从1:20起连续倍比稀释,以出现P/N≥2.1的最高稀释度作为该标本的效价。P值小于0.05认为有显著差异。结果82例子痫前期患者的血清中,抗AT1受体自身抗体的阳性率为69%±2.9%,56例正常孕妇和48例未孕健康妇女(分别为29%±2.1%和8.3%±0.9%,P〈0.01),正常孕妇和未孕健康妇女血清中AT1-AA的阳性率相比也有统计学差异(29%±2.1%vs.8.3%±0.9%,P〈0.05)。子痫前期患者抗体阳性血清的抗体效价为1:168.6±6.7,正常孕妇和未孕健康妇女(分别为1:52.9±2.1和1:16.2±1.8,p〈0.01)。子痫前期患者血清中AT1受体自身抗体的滴度随孕妇收缩压的增高而呈上升趋势。结论AT1-AA和子痫前期可能有关;怀孕过程中可能有免疫机制参与;AT1-AA可能与子痫前期患者血压增高有关。

Objective To understaad the characteristic distribution of AT1-AA- and the relations-hip between the AT1-AA level and the systolic systolic blood pressure (SBP), proteinuria or platelet in preeclamptic patients. Methods Enzyme immunoassay is used to screen the sera from preeclamptic patients. Positively was defined as P/N ≥ 2.1 ; antibody titer was expressed as the maximum dilution at P/N ≥ 2.1. Results Compared with the normal pregnant women and the healthy nonpregnant women, frequency of AT1-AA positive samples was markedly increased in preeclamptic patients (69.0%±2.9% vs. 29.0%±2.1%, 69.0%±2.9% vs. 8.3%±0.9%, respectively, P〈0.01 ) . The antibody titer of the positive sera from preeclamptic patients was in high level with the geometric mean titer being 1 : 168.6+6.7 for anti-AT1 receptor antibody. Notably, the dependability was observed between the AT1-AA level and the systolic blood pressure in preeelamptic patients. Conclusions Overproduction of AT1-AA is a novel risk factor in pregnant women and may play a causative role in the development of preeclamptic patients.