Objective To detect the expression of autoantibodies against angiotensin Ⅱ type 1(AT1)receptor (AT1-AAs)in acute coronary syndrome(ACS)patients and to study the intervention effects of valsartan on ACS patients.Methods Eighty-seven patients with ACS without undergoing intervention therapy were enrolled in this study.Sixty healthy people were selected as healthy control group.The epitopes of the second extracellular loop of AT1-receptor(165-191)were synthesized and used as antigens to screen the serum autoantibodies by enzyme-linked immunosorbent assay(ELISA).The peripheral blood levels of monocyte chemoattractant protein-1 (MCP-1 )and high-sensitivity C-reactive protein(hsCRP)were also evaluated with ELISA.The patients of ACS were divided into AT1-AAs positive group and negative group.Effects of valsartan or normal treatment on MCP-1 and hsCRP were observed. Results ①The positive rates of AT1-AAs in ACS group and healthy control group were 46.0%(40/87)and 5.0%(3/60),respectively.The positive rate of AT1-AAs in ACS group was significantly higher than that in control group(P0.05).Conclusion AT1-AAs may play an important role in the pathogenesis of ACS.In AT1-AAs positive patients,more benefits can get through treatment with valsartan.%目的：检测急性冠状动脉综合征（ACS）患者外周血中血管紧张素Ⅱ1型受体自身抗体（AT1-AAs）表达，探讨血管紧张素Ⅱ受体拮抗剂（ARB）对 AT1-AAs表达阳性的 ACS患者的治疗作用。方法选择未行介入治疗的 ACS患者87例和正常健康对照组60例，人工合成血管紧张素Ⅱ受体细胞外第二环功能表位肽段，采用酶联免疫吸附法（ELISA）检测患者外周血中 AT1-AAs表达阳性率及单核细胞趋化蛋白-1（MCP-1）、高敏C反应蛋白（hsCRP）的表达水平；ACS患者分为2组：AT1-AAs阳性组及阴性组，组内随机给予缬沙坦或常规治疗10天，观察 MCP-1和hsCRP水平的变化。结果①ACS组及正常对照组中 AT1-AAs表达阳性率分别为46．0％（40/87）和5．0％（3/60）， ACS组明显高于正常对照组（P＜0．01），ACS组患者 MCP-1和 hsCRP水平亦明显高于正常对照组（P ＜0．01）；②治疗前，AT1-AAs阳性组 ACS患者 MCP-1和 hsCRP水平明显高于 AT1-AAs阴性组（P＜0．01）；AT1-AAs阳性患者采用缬沙坦治疗后，MCP-1和 hsCRP水平明显低于 AT1-AAs阳性常规治疗者（P ＜0．01），AT1-AAs阴性患者，采用缬沙坦治疗后 MCP-1和 hsCRP水平较常规治疗有降低趋势，但差异无统计学意义（P ＞0．05）。结论 AT1-AAs可能参与 ACS的发病过程，对 AT1-AAs阳性的 ACS患者给予 ARB药物治疗获益更大。
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