Autoimmunological Mechanism in Uremic Cardiomyopathy

尿毒症心肌病(UC)和特发性扩张型心肌病(DCM)心脏病理改变有相似之处。提示UC的发病机制可能与自身免疫机制有关，可能是多因素作用的。我们在实验和临床研究中探讨了自身免疫机制在US发病机制中的作用。与肾功能正常的患者相比，CKD患者中抗心肌抗体的比例更高。其中，抗肾上腺素能受体抗体(β-1ARAb)多见于晚期慢性肾脏病患者。此外，β1ARAb与血液透析患者较低的左心功能显著相关。我们发现移除了。1双滤过血浆置换抗逆转录病毒抗体对β效价较高的UC心力衰竭透析患者有效。综上所述，上述结果提示自身免疫机制在UC的发病机制中起着至关重要的作用。

It has been reported to be some similarities in pathological findings on heart between uremic cardiomyopathy(UC) and idiopathic dilated cardiomyopathy(DCM). The fact suggests that autoimmunological mechanism involve in the pathomechanism of UC, which is likely to be multifactorial. We examined the role of autoimmunological mechanism in the pathogenesis of US in experimental and clinical studies. Anti-myocardium antibodies were more prevalent in patients with CKD, compared with subjects with normal kidney function. Among there antibodies, anti-adrenergic receptor antibody(β1ARAb) was frequently found in patients with advanced CKD. In addition, β1ARAb was significantly associated with lower left ventricular function in patients on hemodialysis. We found that removal of. 1ARAb by DFPP(double filtration plasmapheresis) was very effective in dialysis patients with high titer of βARAb, who suffered from severe heart failure due to UC. Taken together, the results suggest that autoimmulogical mechanism plays a crucial role in the pathogenesis of UC.