| It is widely accepted that the most of the patients suffered from chronic cor pulmonale have been associated with pulmonary hypertension induced by chronic hypoxia. Thus, the pulmonary hypertension is considered as a main reason to produce the chronic cor pulmonale. In recent years, however, some studies have shown that pulmonary hypertension in the patients with ventricular hypertrophy and failure resulted from chronic cor pulmonale was,in the most case ,only mild or moderate. On the other hand, some patients with innate heart diseases have not had hypertrophy and failure for a long time, though they associated with pulmonary hypertension by same extent as the patients with chronic cor pulmonale. It is reasonable.therefore, that there must be some other reasons for it. Only pulmonary hypertension can't explain it completely.For the past ten years, autoantibodies against cardiac ?1-adrenoceptor and M2-muscarinic acetylcholine receptor have been detected in sera from idiopathic dilated cardiomyopathy (IDCM). Experimental studies have shown that the immunizition by peptides corresponding to the sequence of the second extracellular loop of either ?1-adrenoceptor or M2-muscarinic receptors induces morphological changes in the heart similar to those found in IDCM. Further study showed that the antibody against ?1 receptor produced enlarged ventricular cavities in both left and right, while the antibodies against M2 receptor mainly affected right ventricle, which similar to those in chronic cor pulmonale. Therefore, it will be of great clinical significance to detect M2 autoantibodies in sera of patients with chronic cor pulmonale and to study their pathological implications.Our study includes two parts. The First part is clinical sdudy. we have detected the anti- M2-muscarinic receptor autoantibodies in the patients with chronic cor pulmonale. As a control we have also detected these antibodies in healthy subjects and the patients with other heart diseases under the same conditions. Artery gases analyses, pulmonary function and Doppler color echocardiogram examinations have been measured as the evalution index in immunodepressive therapy in order to understand the relationship between the clinical profile and the anti- M2-muscarinic receptor autoantibodies. The Second part is experimental study. we have done some experimental studies on the animals in order to further study the role of autoantibodies against cardiac M2-muscarinic acetylcholine receptor in the pathogenesis of chronic cor pulmonale.Part one The relationship between the autoantibodies against M2-muscarinic receptor in sera from chronic cor pulmonale and pathogenesis of chronic cor pulmonale and the effects of immunodepressive therapyMATERIALS and METHODSThe patients were divided into 5 groups: 86 patients with chronic cor pulmonale, 31 patients with chronic bronchitis, 35 patients with bronchial asthma, 24 patients with hypertension and 20 patients with coronary heart disease. All patients were collected from in-patients at the First Hospital of Shanxi Medical University. Healthy subjects, as the control group,were collected from normal subjects for health examination at the First Hospital of Shanxi Medical University. The sera from the subjects was assessed with SA-ELISA immunoassay. All the patients were consistent with the diagnostic criteria. Of the 86 patients with chronic cor pulmonale, 60 patients were chosen to observe the curative effects and divided randomly into two groups, treatment group (n=30) and control group (n=30). The treatment group was treated with dexamethasone (10mg/d) and routine treatment with antibiotics, bronchial dilator and anti-symptem treatments for two weeks. The control group was only treated with routine treatment. All 86 patients were examined by artery gases analyses, pulmonary function and Doppler color echocardiogram examinations and the 60 patients were chosen to observe the curative effects were examined against 2 weeks after treatment. RESULTSThe rates of positive antibody...
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