Objective: To study the relationship between autoantibodies to myocardium β1-adrenergic receptor (β1-receptor), M2-muscarinic receptor (M2-receptor) and hypertrophic cardiomyopathy (HCM) in relevant patients. Methods: Our research included in 2 groups: HCM group, n=81 patients and Control group, n=50 normal subjects. Synthetic peptides corresponding to amino acid sequence of second extracellular loops of β1-receptor and M2-receptor were used as antigens, ELISA was conducted to detect serum autoantibodies to β1-receptor and M2-receptor in both groups. Results: ① Compared with Control group, HCM group had the higher positive rates of autoantibodies as for β1-receptor was 58.02% (47/81) vs 12.00% (6/50) and for M2-receptor was 44.44 % (36/81) vs 10.00% (5/50), both P<0.05. ② Compared with Control group, HCM group had the higher mean geometric titers of autoantibodies as for β1-receptor was 1:85 vs 1:36 and for M2-receptor was 1:80 vs 1:35, both P<0.05. ③ In HCM group, 43.48 % patients with positive autoantibody to β1-receptor meanwhile have autoantibody to M2-receptor. Conclusion: HCM patients having both autoantibodies to β1-receptor and M2-receptor might be related to cardiac structure change and diastolic function decreasing. Both positive antibodies implies that immunological mechanism has been involved in pathophysiological process in HCM patients.%目的:探讨心脏 β1肾上腺素能受体和M2乙酰胆碱能受体的自身抗体与肥厚型心肌病的相关性.方法:以细胞外第二环表位肽段的合成肽作为抗原,应用酶联免疫吸附技术,检测81例肥厚型心肌病患者(肥厚型心肌病组)和50例健康受试者(正常对照组)血清中心脏 β1肾上腺素能受体和M2乙酰胆碱能受体的自身抗体.结果:(1)肥厚型心肌病组 β1受体自身抗体的阳性率为58.02%(47/81),明显高于正常对照组12.00%(6/50),差异有统计学意义(P<0.05);肥厚型心肌病组M2乙酰胆碱能受体自身抗体阳性率为44.44%(36/81),显著高于正常对照组10.00%(5/50),差异有统计学意义(P<0.05).(2)肥厚型心肌病组 β1肾上腺素能受体和M2乙酰胆碱能受体的自身抗体的平均几何滴度分别为1:85和1:80,显著高于正常对照组的1:36和1:35,差异有统计学意义(P<0.05).(3)肥厚型心肌病组 β1肾上腺素能受体自身抗体阳性血清中43.48%(20/46)的患者同时具有M2乙酰胆碱能受体的自身抗体.结论:肥厚型心肌病患者血清中存在心脏 β1肾上腺素能受体和M2乙酰胆碱能受体的自身抗体,可能与其心肌结构变化和舒张功能下降有关.心脏 β1肾上腺素能受体和M2乙酰胆碱能受体的双抗体阳性可能是自身免疫反应的多重性表现,提示免疫学机制参与肥厚型心肌病的病理生理过程.
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