慢性肾小球肾炎患者血清β1及M2受体自身抗体变化.doc

慢性肾小球肾炎患者血清β1及M2受体自身抗体变化 　 作者：赵林双，廖玉华，王敏，向光大，候洁，乐岭，兰天飚，王旭，王平 【关键词】 肾小球 Changes of autoantibodies against β1 adrenergic receptor and M2 cholinergic receptor in chronic glomerulonephritis with renal failur 【Abstract】 AIM: To explore the role of autoantibodies against M2 muscarinic cholinergic receptor（M2 receptor） and β1 adrenergic receptor（β1 receptor）in the development of chronic glomerulonephritis (CGN) with renal failure. METHODS: The epitopes of the second extracellular loop of M2 receptor (169-191) and β1 receptor (197-222) were synthesized and used respectively to screen serum autoantibodies from patients with CGN with renal failure (n=66), hypertension patients without renal failure (n=58) and healthy blood donors (n=40, control) by ELISA. RESULTS: In CGN patients with renal failure, the positive rates of the autoantibodies against β1 receptor and M2 receptor were 62.1% and 48.5% respectively, which were both higher than those in the hypertension patients without renal failure (19.0% and 20.7% respectively) and the healthy donors (17.5% and 15.0% respectively) (Plt;0.01). CONCLUSION: These autoantibodies against β1 receptor and M2 receptor may play some important roles in the pathogenesis of CGN with renal failure. 【Keywords】 chronic glomerulonephritis; receptors; autoantibodies 【摘要】 目的：探讨M2受体和β1受体自身抗体与慢性肾小球肾炎（CGN）发病的关系. 方法：以合成的M2受体和β1 受体多肽片段为抗原，用ELISA技术检测66例CGN患者、 58例高血压无肾损害患者及40例正常人血清中M2和β1受体自身抗体. 结果：CGN组β1和M2受体抗体阳性率分别为62.1%和48.5%，明显高于高血压无肾损害组（19.0%和20.7%）及正常对照组（17.5%和15.0%）（Plt;0.01）. 结论：血清中M2和β1受体自身抗体可能与CGN发病有关. 【关键词】 慢性肾小球肾炎； 受体； 自身抗体 0引言 近来研究发现在难治性高血压患者血清中，检出抗AT1和α1受体自身抗体，这些患者合并肾损害频率明显增高［1］ . 我们拟检测慢性肾小球肾炎（chronic glomerulo nephritis, CGN）及高血压无肾损害以及正常人血清中抗M2胆碱能受体（M2受体）和β1肾上腺素受体（β1受体）自身抗体，探讨其与CGN肾损害的关系. 1对象和方法 1.1对象200101/200211确诊CGN 66（男30，女36）例，年龄（40.4±5.2）岁，均按照慢性原发性肾小球肾炎诊断标准［2］确诊. 排除继发性肾小球疾病，原发性高血压及肾囊肿、泌尿系结石. 高血压无肾损害患者58（男41，女17）例，年龄（59.4±10.5）岁，诊断参照1999 WHO/ISH高血压防治指南［3］. 健康对照组40（男22，女18）例，平均年龄（44.9±7.4）岁，来自健康体检者，胸部正侧位片、心电图、生化检查正常；肝肾功能、血清电解质、