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目的:探讨原发性高血压并发心肌梗死患者抗血管紧张素Ⅱ1型受体自身抗体(angiotensinⅡtype 1 receptor-activating antibody,AT1-AA)改变与AT1-AA对鼠冠脉血管的影响。方法:选取2014年6月至2015年7月我院收治的原发性高血压并发心肌梗死患者47例(高血压+心肌梗死组)、高血压患者96例(高血压组)、心肌梗死患者53例(心肌梗死组),随机选取同期到我院接受体检的健康者65例组成健康对照组,比较4组受试者的AT1-AA滴度、水平、阳性率及不同浓度AT1-AA下鼠冠脉血管指标。结果:高血压+心肌梗死组患者的AT1-AA滴度、水平及阳性率均明显高于高血压组和心肌梗死组,3组患者的AT1-AA滴度、水平及阳性率明显高于健康对照组,差异具有统计学意义(P<0.05)。0、10-8、10-7、10-6 mol/L浓度下,鼠冠脉血管环静息张力分别为(0.15±0.09)m N、(0.27±0.15)m N、(0.69±0.18)m N、(1.14±0.23)m N,冠脉粥样硬化斑块面积分别为(2.45±0.47)%、(11.78±2.78)%、(19.16±2.52)%、(26.79±4.91)%,组间差异具有统计学意义(P<0.05),并随AT1-AA浓度变化而变化,趋势显著(P<0.05)。鼠冠脉血管环静息张力(r=0.792,P=0.026)、冠脉粥样硬化斑块面积(r=0.720,P=0.031)与AT1-AA均呈明显正相关关系。结论:原发性高血压并发心肌梗死患者的AT1-AA水平明显升高,AT1-AA可导致鼠冠脉血管收缩能力增加及粥样硬化斑块面积扩大。
OBJECTIVE: To investigate the effect of AT1-AA on angiotensin Ⅱ type 1 receptor (AT1-AA) in patients with essential hypertension complicated with myocardial infarction. Methods: Forty-seven patients with essential hypertension complicated with myocardial infarction (hypertension + myocardial infarction group), 96 patients with hypertension (hypertension group) and patients with myocardial infarction (MI) were selected from June 2014 to July 2015 in our hospital. 53 cases (myocardial infarction group) were randomly selected from the same period to our hospital for examination of healthy healthy 65 patients to form a healthy control group, AT1-AA titers, levels, positive rate and AT1-AA Rat coronary vascular index. Results: The AT1-AA titer, level and positive rate in patients with hypertension and myocardial infarction were significantly higher than those in hypertension group and myocardial infarction group. The AT1-AA titers, levels and positive rates in patients with hypertension and myocardial infarction were significantly higher than those in healthy Control group, the difference was statistically significant (P <0.05). The resting tension of the rat coronary artery rings were (0.15 ± 0.09) m N, (0.27 ± 0.15) m N, (0.69 ± 0.18) m, 0-10-8,10-7 and 10-6 mol / (1.14 ± 0.23) m N and (2.45 ± 0.47)%, (11.78 ± 2.78)%, (19.16 ± 2.52)% and (26.79 ± 4.91)%, respectively (P <0.05), and with the change of AT1-AA concentration, the trend was significant (P <0.05). Resting tension of rat coronary artery rings (r = 0.792, P = 0.026) and coronary atherosclerotic plaque area (r = 0.720, P = 0.031) were positively correlated with AT1-AA. CONCLUSIONS: The AT1-AA levels in patients with essential hypertension complicated with myocardial infarction are significantly increased. AT1-AA can lead to increased vasoconstrictive ability of coronary arteries and enlargement of atherosclerotic plaque area.