【摘要】 目的探讨肺心病病人抗M2、M3受体自身抗体的产生、作用及其与右心结构的关系。方法用SA-ELISA法对108例肺心病病人和30名健康人血清中抗M2、M3受体自身抗体进行检测,并与血气分析及心脏超声学检查结果进行比较。结果肺心病组病人血清抗M2、M3受体自身抗体的阳性率及平均几何滴度[48.15%,80(1.846±0.351);40.74%,53(1.725±0.273)]均高于对照组[13.33%,40(1.602±0.369);10.00%,20(1.301±0.000)](P<0.05)。对照组与肺心病组中M2受体自身抗体阴性组、阳性组指标比较及对照组与肺心病组中M3受体自身抗体阴性组、阳性组指标比较均表现为:血氧分压(PaO2)呈逐渐降低趋势,二氧化碳分压(PaCO2)、右室流出道内径、右室内径呈逐渐增高趋势(P<0.05)。肺心病病人M3受体自身抗体单阳性组,M2受体自身抗体单阳性组,M2、M3受体自身抗体双阳性组在心脏指标方面,3组呈逐渐增高趋势(P<0.05)。结论M2、M3受体自身抗体可能与肺心病的发病过程密切相关;M2、M3受体自身抗体可能与肺心病发病过程中的心脏损害有关;M2受体自身抗体在肺心病发病过程中可能起着较M3受体自身抗体更为主要的作用,两者在心脏形态学改变过程中可能起着协同作用。更多还原

【Abstract】 Objective To study the effects of anti-M2 muscarinic receptor autoantibody and anti-M3 muscarinic receptor autoantibody on the cardiac function and structure in patients (pts) with chronic cor pulmonale.Methods The data of clinical examination, blood gas analysis and Doppler color echocardiogram examination were collected in 108 pts with chronic cor pulmonale and 30 subjects as control.Results The positive rate and the mean geometric titers of the autoantibodies against M2-muscarinic receptor and M3-muscarinic receptor in the patients [48.15%, 80 (1.846±0.351); 40.74%, 53 (1.725±0.273)] were significantly higher than that of control group[13.33%,40 (1.602±0.369); 10.00%, 20 (1.301±0.000)] (P<0.05). PaO2 decreased gradually for control group, negative and positive group of anti-M2 muscarinic receptor autoantibody. PaCO2, right ventricular outflow tract inner diameter and right ventricular inner diameter increased gradually. Cardiac index increased gradually in positive group of anti-M2 muscarinic receptor autoantibody, positive group of anti-M3 muscarinic receptor autoantibody and double positive group of both autoantibodies (P<0.05). Conclusion The positive rate and the antibody titer of autoantibodies in pts were obviously higher than that in control group, which suggested that there was a close relationship between both autoantibodies and the pathogenesis of chronic cor pulmonale.The heart damage in the patients with the positive of both autoantibodies was more serious than that in the patients with the negative ones.Anti-M2 muscarinic receptor autoantibody might play a more important role than anti-M3 muscarinic receptor autoantibody for chronic cor pulmonale. Both autoantibodies possibly had synergistic effect in heart morphology change.更多还原