摘要
目的探讨心脏β1和M2受体自身抗体在缺血性心肌病患者心房颤动(AF)中的作用。方法连续选取116例确诊缺血性心肌病患者,以合并有AF的41例为观察组(A组),以无AF的75例为对照组(B组),以同期年龄、性别相匹配的体检健康者50例为空白对照组(C组),对比3组受试者一般临床资料、血生化指标,超声心动图数据以及心脏β1和M2受体自身抗体滴度和阳性率。分析上述2种心脏受体自身抗体与其他指标的关系。结果 (1)A、B两组在β1和M2受体自身抗体滴度和阳性率、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)、左室舒张末期内径(LVDd)、左房内径(LAD)等方面明显高于C组,左室射血分数(LVEF)则明显低于C组,差异有统计学意义(P<0.05,P<0.01)。(2)A、B两组相较,仅在LAD、LVEF、β1和M2受体自身抗体滴度和阳性率等方面差异有统计学意义(P<0.01)。(3)Pearson线性相关分析显示,上述两种心脏受体滴度与SBP、DBP、LVDd、LAD呈正相关(P<0.01,P<0.05),与LVEF呈负相关(P<0.01)。(4)Logistic多元逐步回归分析,并校正年龄、性别、血压等因素影响,上述两种心脏受体自身抗体仍是缺血性心肌病患者发生AF的独立危险因素。结论以心脏β1和M2受体自身抗体为代表的自身免疫机制可能参与了缺血性心肌病患者心房颤动的发生和发展。
Objective To investigate the correlation between cardiac beta1 or M2 receptor auto-antibodies in patients with ischemic cardiomyopathy and atrial fibrillation. Methods Continuous selection of 116 patients with ischemic cardiomyopathy,including 41 cases complicated with atrial fibrillation as observation group(Group A),and 75 cases without atrial fibrillation as control group(Group B).Meanwhile,50 health subjects with matched age and sex in medical examination were enrolled as blank control group(Group C).The clinical data,blood biochemical index,ultrasound heartbeat graph data and cardiac beta1 and M2 receptor autoantibody titers and positive rates. Results(1) Significantly lower beta1 and M2 receptor autoantibody titers and positive rates,total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),systolic blood pressure(SBP),diastolic blood pressure(DBP),left ventricular end diastolic diameter(LVDd),left atrial diameter(LAD),and left ventricular ejection fraction(LVEF) were revealed in Group A and B,comparing with those in Group C(P<0.01 or P<0.05).(2) There were significant differences revealed only in LAD,beta1 and M2 receptor autoantibody titers and positive rates between Group A and B(P<0.01).(3) According to Pearson linear correlation analysis,the two cardiac receptor titers were significantly positively correlated with SBP,DBP,LVDd and LAD(P<0.01 or P<0.05),and significantly negatively correlated with LVEF(P<0.01).(4) In Logistic stepwise multiple regression analysis,adjusted with age,gender,and blood pressure,the cardiac beta1 and M2 receptor autoantibodies were the independent risk factors of atrial fibrillation in patients with ischemic cardiomyopathy. Conclusion The autoimmune system,representing as cardiac beta1 and M2 receptor autoantibodies,may be involved pathogenesis of atrial fibrillation in patients with ischemic cardiomyopathy.
出处
《广东医学》
CAS
CSCD
北大核心
2011年第24期3188-3190,共3页
Guangdong Medical Journal
基金
武汉市卫生局临床医学科研项目(编号:WX11D14)
关键词
心脏
β1和M2受体自身抗体
缺血性心肌病
心房颤动
heart
beta1 and M2 receptor autoantibodies
ischemic cardiomyopathy
atrial fibrillation
