β受体阻滞剂治疗扩张型心肌病药理机制的探讨

采用心肌细胞毒试验，对１１例扩张型心肌病患者血清中抗β受体抗体进行研究，发现该抗体引起心肌细胞毒性损害，具有钙依赖性；倍他乐克能够抑制细胞毒性反应，使细胞死亡率均值从７０．８２±８．０４％降到３８．５５±１０．５２％（Ｐ＜０．０１）；正常人血清无此反应．提示抗β受体抗体通过受体门控机制介导心肌细胞毒性损害；β受体阻滞剂可以预防免疫性心肌损害，是治疗扩张型心肌病的新型药理机制．

The Study of the Mechanism of β-adrenoceptor Blocker Treatment in Dilated Cardiomyopathy

Antibodies against β-adrenoceptor in sera of 11 patients with dilated cardiomyopathy was studied with myocardial cytotoxic test.The antibody induced myocardial cytotoxic damage and cytotoxic reaction were calcium-dependent and might be inhibited by metaprolol. The mean cell mortality reduced from 70. 82±8. 04% to 38.55 ± 10. 52 % in the metaprolol group(P<0.01),and the reaction was null in control sera.Above findings suggest that the antibody against The β-adrenoceptor mediate through the receptor-gated mechanism causes myocardial cytotoxic damage,β-adrenoceptor blockers may prevent the immune myocardial damage.It may be a novel pharmacological mechanism of the β-adrenoceptor blocker treatment in dilated cardiomyopathy.