Autoimmunological Mechanism in Uremic Cardiomyopathy

尿毒症性心肌病（UC）与特发性扩张型心肌病（DCM）的心脏病理表现有相似之处。提示自身免疫机制参与了UC的发病机制，可能是多因素的。我们在实验和临床研究中研究了自身免疫机制在US发病机制中的作用。与肾功能正常的受试者相比，抗心肌抗体在CKD患者中更普遍。其中抗肾上腺素能受体抗体（β1ARAb）在晚期CKD患者中最常见。此外，在血液透析患者中，β1ARAb与左心室功能降低显著相关。我们发现移除。1DFPP法（double filtration plasmapheresis，双重滤过血浆置换法）对βARAb滴度高、合并严重心力衰竭的UC患者治疗效果显著。这些结果提示自身免疫机制在UC的发病机制中起着重要作用。

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.