高血压合并急性冠脉综合征患者AT1-AA水平变化及AT1-AA对大鼠冠状动脉血管的影响

摘要

目的 观察高血压合并急性冠脉综合征(ACS)患者血清抗血管紧张素Ⅱ1型受体自身抗体(AT1-AA)水平及AT1-AA对离体高脂大鼠冠状动脉前降支血管环静息张力影响.方法 将2007年6月至2008年8月山西省心血管病医院心内科患者分为:高血压合并ACS组(n=120)、单纯高血压组(n =253)及单纯ACS组(n=115例),同期门诊健康体检者作为健康对照组(n=188).合成AT1受体胞外第二环肽段作为抗原(AT1-Ag),SA-ELISA检测血清AT1-AA水平;微血管环张力技术测定离体大鼠冠状动脉前降支血管环静息张力.结果 单纯高血压和单纯ACS组血清AT1-AA阳性率均明显高于对照组[(35.2％比7.2％)和(30.4％比7.2％)](均P＜0.01);高血压合并ACS组AT1-AA阳性率明显高于单纯高血压组(43.3％比35.2％,P＜0.05)和单纯ACS组(43.3％比30.4％,P＜0.05);AT1-AA可增加离体高脂大鼠冠脉前降支血管环静息张力,其增加血管环静息张力幅度相当于血管紧张素Ⅱ的46.4％,并呈现浓度依赖性;且该收缩血管作用可被氯沙坦及AT1-Ag阻断.结论 高血压合并ACS患者血清AT1-AA水平显著增高;AT1-AA可增加离体大鼠冠脉前降支血管环静息张力引起的血管收缩效应.%Objective To explore the levels of autoantibodies against AT1-receptor (AT1-AA) in hypertensive patients with acute coronary syndrome (ACS) and observe the in vitro effects of AT1-AA on resting tension of isolated anterior descending artery of vascular ring in male Wistar rats.Methods All patients were recruited from June 2007 to August 2008.There were hypertensive patients with ACS (n =120),those with simple hypertension (n =253) and those with simple ACS (n =115).And the outpatients for health examination during the same period were selected as healthy control group (n =188).The second extracellular loop amino acid sequences of peptides of ATI receptor was synthesized and used as antigen (AT1-Ag) and sialic acid-enzyme-linked immunosorbent assay (SA-ELISA) for detect the serum levels of AT1-AA.Microvascular ring tension technology was used to test the vascular loop resting tension of anterior descending coronary artery from rats induced by a high-fat diet.Results The positive rates of AT1-AA in patients with simple hypertension(35.2％) and those with simple ACS (30.4％) were significantly higher than those in healthy control group (7.2％,P ＜ 0.01).And the positive rate of AT1-AA in hypertensive patients with ACS (43.3％) was significantly higher than that in those with simple hypertension (35.2％,P ＜ 0.05) and that in healthy control group (7.2％,P ＜ 0.05).Furthermore,AT1-AA increased the vascular loop resting tension of anterior descending coronary artery rings in rats induced by a high-fat diet in a dose-dependant manner.And the vasoconstrictive action of AT1-AA was equal to 46.4％ of Ang Ⅱ's action.And such an action was blocked by losartan and antigens.Conclusion The level of AT1-AA increases markedly in hypertensive patients with ACS.And AT1-AA induces vasoconstrictive effects on anterior descending artery rings in rats induced by a high-fat diet.