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病毒性心肌炎与扩张型心肌病血清抗M受体抗体研究 |
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A study of anti-muscarinic receptor antibodies in sera fro
m patients with viral myocarditis and dilated cardiomyopathy
苏恩本 杨笛 王晖 徐晋丹 张寄南 马文珠
Su Enben, Yang Di, Wang Hui, et al
【摘要】 目的 M受体和肾上腺素能受体通过自主神经调节心脏功能。在某些
病理条件下，血清抗M受体抗体的产生与疾病的发生、发展密切相关。本研究拟
通过对病毒性心肌炎(VMC)与扩张型心肌病(DCM)患者血清抗M受体抗体的检测，探
讨该指标的辅助判断价值。方法 随机选择VMC患者32例、DCM患者12例、冠心病
患者20例及正常对照组14例，受试者血清与人心室肌组织片预孵育后，冷冻切片
法测定M受体与配基［3H］QNB结合的Bmax与Kd值。VMC患者血清同时进行心肌肌钙
蛋白Ⅰ(cTnⅠ)测定与淋巴细胞肠道病毒逆转录扩增。结果 7例正常人(意外死亡
者)心室肌M受体与配基［3H］QNB结合的Bmax值为51.4±6.0 fmol/L·mg pr, Kd值为
0.68±0.09 nmol/L。DCM患者血清孵育后M受体和配基结合的Bmax值下降(P〈0.01),
Kd值升高(P〈0.01)；VMC患者仅Kd值升高(P〈0.01)，但cTnI阳性及病毒扩增阳性
者Bmax值同时下降(P〈0.05)。结论 VMC和DCM患者血清中存在抗M受体抗体，其
导致心肌M受体和配基结合的数目与亲和力改变，对DCM诊断以及VMC向DCM演变可
能提供有益的证据。
【关键词】 心肌病，充血性 心肌炎 受体，胆碱能 自身抗体
A study of anti-muscarinic receptor antibodies in sera from patients with viral myocarditis
and dilated cardiomyopathy Su Enben, Yang Di, Wang Hui, et al. The First Affiliated Hospital,
Nanjing Medical University, Nanjing 210029
【Abstract】 Objective Muscarinic receptor (MR) and adrenergic receptors in human heart play
an important role in maintaining physiologic function. In some clinical cases, the level of serum anti-MR
antibodies was reported to be related to the pathogenesis and progress of diseases. This work was
designed to investigate the concentration of anti-MR autoantibodies in sera from patients of viral
myocarditis (VMC) and dilated cardiomyopathy (DCM) and evaluate the significance as a diagnostic
marker. Methods Thirty two patients with VMC, 12 DCM, 20 coronary heart disease (CHD)
(total 64 cases) and 14 normals were enrolled and blood samples were collected. The level of
autoantibodies in sera was determined by inhibition of 3H-QNB binding on incubation left ventricular
slide with the patients′ sera. S[1] [2] [3] 下一页
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