| Objective:The pathogenesis of essential hypertension is complicated.At present,it is believed that it is the result of both the environment factors and the inheritance factors,and belongs to multigenic herediatory disease.Alterations in systemic hemodynamics,the renal handling of salt and water,the renin-angiotensin-aldosterone system,sympathetic activity,genetic mechnisms,and diet have been implicated to varying degrees in the pathogenesis of hypertension. Although considerable attention has been focused on these elements,evidence has accumulated suggesting that in many forms of experimental as well as human essential hypertension,alterations in immune function may contribute significantly to the etiology of the disease.However, whether altered immunological function is a primary factor in the pathogenesis of hypertension or secondary to tissue damage of vascular beds induced by hypertension is still poorly defined. Lately,by using the peptide corresponding to the sequence of the second extracellular loop of human a 1-adrenoceptors and angiotensin- II receptors,sera from patients with malignant essential hypertension and malignant secondary hypertensionshowed autoantibodies against the a 1-adrenoceptors and angiotensin-II receptors.Both these autoantibodies displayed an agonist-like activity and their effects could be abolished by their corresponding antagnists.In order to elucidate further in great detail the role of immuglobulins and these two autoantibodies in the pathogenesis of essential hypertension,we conduct this study.Methods:We selected 101 patients with essential hypertension.Of these,41 patients had coronory heart disease(CHD),16 patients had cerebral infarction.Another 54 healthy subjects were selected as the control proup.None of these subjects had any infectiousdisease,glomerulonephritis,hepatitis,maligant or benign tumor,self-immune disease. The serum concentrations of IgG, IgA,IgM,IL-2 were measured and the presence of a IRA, AT IRA was tested after fasting for 10 hours.(l) IgG, IgA,IgM:We used the method of laser-immune-turbidimetric to measure them;(2) IL-2:The method of radioimmunoassay was used.(3) a lRA,ATlRA:The method of enzyme-linked immunosorbent assay was used.(4) Left Ventricular Hypertrophy(LVH):We used Doppler echocardiograms to measure the IVSTd,LVPWTd,LVDd and caculated the LVM and LVMI.The criterion for LVH is equal or larger than 134g/L in man and for woman the criterion is equal or larger than HOg/L.Results:(l):The comparison of the concentrations of IgG, IgA,IgM,IL-2 between the patients with essential hypertension and the controlsrThe levels of IgG, IgA and IL-2 in the patients with essential hypertension were 12.71g/L,2.70g/L,5.51ng/L respectively,while in the controls the concentrations of IgG, IgA and IL-2 were 11.29g/L,2.21g/L,4.75ng/L,the concentrations of IgG, IgA and IL-2 were higher in patients with essential hypertension than those in the controls(P < 0.01).There was no significant difference in the level of IgM between the patients with essential hypertension and the controls.The patients with essential hypertension were divided into two groups according to their accompanied disease:Sub-group:These patients only had hypertension; Sub-group:They had both hypertension and cardiovascular disease.The concentrations of IgG, IgA were higher in both the Sub-groupand the Subgroup than those in the controls(P<0.05),while there was no significant difference in the concentrations of IgG, IgA,IgM,IL-2 between Sub-group and sub-group(2).(2)The comparison of the positive ratio of a IRA and AT IRA between patients with essential hypertension and the controls: The positive ratio of a IRA and AT IRA was higher in patients with essential hypertension than that in the controls(P<0.05).In patients with essential hypertension,the positive ratio of a IRA and AT1RA was 25.7% and 19.8% respectively,while in the control group,the positive ratio of aIRA and AT1RA was 9.3% and 5.6% respectively.The positive ratio of a IRA was...
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