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目的探讨T2DM患者血清抗血管紧张素II 1受体(AT1受体)和β1受体自身抗体(β1受体)与冠心病(CHD)的关系。方法采用随机对照的方法,选择T2DM患者371例(T2DM组)和健康对照者40名(NC组),以合成的AT1和β1受体多肽片段为抗原,应用ELISA法检测被试血清中抗G-蛋白偶联型AT1和β1受体自身抗体。使用超声心动图检查评价心脏结构和功能。多元Logistic回归分析T2DM患者CHD的影响因素。结果 (1)T2DM组抗AT1和β1受体抗体阳性率高于NC组(P<0.01)。(2)T2DM患者中,AT1受体抗体阳性组CHD发生率高于受体抗体阴性组(P<0.01);β1受体抗体阳性组CHD发生率高于受体抗体阴性组(P<0.01);(3)多元Logistic回归分析显示,病程、SBP、β1和AT1受体抗体4个危险因素与T2DM合并CHD相关(P<0.05)。结论 T2DM合并CHD可能与血清β1和AT1受体自身抗体参与有关,该抗体阳性预测T2DM合并CHD具有重要意义。
Objective To investigate the relationship between serum anti-angiotensin II 1 receptor (AT1 receptor) and β1 receptor autoantibody (β1 receptor) and coronary heart disease (CHD) in patients with T2DM. Methods A randomized controlled study was conducted in 371 T2DM patients and 40 healthy controls (NC group). The AT1 and β1 receptor peptide fragments were used as the antigen. The anti-G Protein-coupled AT1 and β1 receptor autoantibodies. Echocardiography was used to evaluate cardiac structure and function. Influential Factors of CHD in Patients with T2DM by Multivariate Logistic Regression. Results (1) The positive rate of AT1 and β1 receptor antibodies in T2DM group was higher than that in NC group (P <0.01). (2) The incidence of CHD in AT1 receptor antibody-positive group was higher than that in receptor antibody negative group (P <0.01). The incidence of CHD in β1 receptor antibody positive group was higher than that in receptor antibody negative group (P <0.01) ; (3) Multivariate logistic regression analysis showed that the four risk factors of duration of disease, SBP, β1 and AT1 receptor antibodies were associated with T2DM with CHD (P <0.05). Conclusions T2DM combined with CHD may be related to the involvement of β1 and AT1 autoantibodies in T2DM. The positive predictive value of this antibody in T2DM combined with CHD is of great significance.