血管紧张素Ⅱ1型和α1肾上腺素能受体抗体对预测老年2型糖尿病合并冠心病患者死亡危险性分析

目的 探讨血清抗血管紧张素Ⅱ 1型和α1肾上腺素能受体抗体与老年T2DM合并冠心病（CAD）患者死亡危险性的关系. 方法 选取老年T2DM患者234例,根据是否合并CAD平均分为T2DM合并冠心病（T2DM＋CAD）组和单纯糖尿病（T2DM）组,进行追踪研究3～11年.以合成的α1R和AT1R多肽片段为抗原,应用酶联免疫吸附法检测上述患者血清中抗α1R和AT1R自身抗体. 结果 （1） T2DM＋CAD组AT1R和α1R抗体阳性率高于T2DM组（48.7％ vs 20.5％,36.8％vs21.4％,P＜0.01）；（2）T2DM＋CAD组抗α1R和AT1R抗体受体阳性组死亡率高于受体抗体阴性组（47.4％vs10.0％,P＜0.01）；（3）α1R和AT1R抗体阳性组（指同一个体α1R和AT1R均阳性）死亡率高于单抗体阳性组（指同一个体仅α1R或AT1R阳性）（37.2％ vs 11.6％ vs 12.3％,P＜0.01）. 结论 α1R和AT1R抗体阳性与老年T2DM合并CAD患者死亡的危险性增高有关,双抗体阳性是老年T2DM合并CAD患者死亡的危险因素.

The role of autoantibodies against α1-adrenergic receptor and AT1-receptor in predicting death risk from coronary heart disease in elderly patients with type 2 diabetes mellitus

Objective To explore the relationship between autoantibodies against α1 adrenergic receptors （α1-receptor） and angiotensin Ⅱ type 1 receptors （AT1-receptor） and the death risk of elderly type 2 diabetic patients with coronary artery disease（CAD）.Methods A total of 234 elderly type 2 diabetic patients with CAD was divided in average into groups of T2DM with CAD（T2DM＋ CAD） and T2DM without CAD（T2DM） to perform a 3～11 year follow-up study.In this study,synthetic peptide fragments of α1 R and AT1 R as antigen were used to test the serum autoantibodies by enzyme-linked immunosobent assay （ELISA）.Results （1） The positive rates of the autoantibodies against AT1R and α1R in T2DM＋CAD group were higher than in group of T2DM without CAD（48.7％ vs 20.5％ and 36.8％ vs 21.4％） respectively,P＜0.01.（2）The death rate of CAD in the disease group positive of the autoantibodies against α1R and AT1R was 47.4％,which was higher than 10.0％ in the disease group negative of the autoantibodies against α1R or AT1R（P＜0.01）.（3）The death rate of CAD in the disease group positive of the autoantibodies against α1 R and AT1 R was 37.2％,which was higher than 12.3％ and 11.6％ in the disease group positive of the autoantibodies against AT1R or α1R.Conclusion The positive rates of the autoantibodies against α1 R and AT1 R are related to the risk of CAD death in elderly patients with type 2 diabetes mellitus.