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目的观察抗血管紧张素Ⅱ1型受体(AT_1受体)自身抗体对原发性高血压患者心脏重构的影响。方法采用酶联免疫吸附法(ELISA)对592例原发性高血压患者进行血清 AT_1受体自身抗体检测,并记录患者心脏超声心动图的检查结果。以血清中抗体测定结果将病例分为抗体阳性组和阴性组,运用 t 检验和 X~2检验比较抗体阳性组和抗体阴性组的血压、高血压病病程、血管活性物质和心脏超声结构等的组间差异,运用多元 logistic 回归分析高血压患者左心室扩大的影响因素。结果592例原发性高血压患者抗 AT_1受体自身抗体阳性率为38.0%(225/592)。抗 AT_1受体自身抗体阳性组右心房和左心室内径明显大于抗体阴性组(分别 P=0.049,P=0.044,P<0.05)。多元 logistic回归共筛选出4个左心室扩大相关的因素,即血清抗 AT_1受体自身抗体、男性、高血压病病程和舒张压(P<0.05)。结论抗 AT_1受体自身抗体与原发性高血压患者左心室和右心房扩大有关。
Objective To investigate the effect of anti-angiotensin Ⅱ type 1 receptor (AT_1 receptor) autoantibodies on cardiac remodeling in patients with essential hypertension. Methods Serum AT_1 receptor autoantibodies were detected in 592 essential hypertension patients by enzyme - linked immunosorbent assay (ELISA), and the results of echocardiography were recorded. Serum antibody results were divided into antibody positive and negative cases, using t test and X ~ 2 test to compare the antibody positive group and antibody negative group’s blood pressure, duration of hypertension, vasoactive substances and cardiac ultrasound structure Differences between groups, using multivariate logistic regression analysis of factors affecting left ventricular enlargement in hypertensive patients. Results The positive rate of anti-AT_1 receptor autoantibody in 592 patients with essential hypertension was 38.0% (225/592). The right atrium and left ventricular diameter of anti-AT_1 receptor autoantibody positive group were significantly larger than that of antibody negative group (P = 0.049, P = 0.044, P <0.05). In multivariate logistic regression, four factors related to left ventricular enlargement were screened: serum anti-AT1 receptor autoantibodies, male, duration of hypertension and diastolic blood pressure (P <0.05). Conclusion Anti-AT_1 receptor autoantibodies are associated with enlarged left ventricle and right atrium in patients with essential hypertension.