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目的 探讨心房颤动患者心房肌组织醛固酮合成酶 (CYP11B2 )的mRNA表达情况。方法 38例因心脏疾患住院接受开胸手术的患者 ,男 18例 ,女 2 0例 ,年龄 18～ 77岁 ,平均 (5 1.92± 14 .0 0 )岁。按有无心房颤动病史分为 3组 :窦性心律组 (SR组 ) ,11例 ;阵发性心房颤动组 (pAF组 ,心房颤动持续时间 <6个月 ) ,13例 ;慢性心房颤动组 (cAF组 ,心房颤动持续时间 >6个月 ,14例。半定量聚合酶链式反应技术测定CYP11B2mRNA在心房肌组织中的表达情况。结果 与SR组和 pAF组相比 ,cAF组患者左心房直径明显增大 (分别增大 78.8%和 37.5 % ,P <0 .0 1) ,CYP11B2mRNA表达水平明显升高 (分别升高 81%和 11.8% ,P <0 .0 5～ 0 .0 1) ,并与左心房直径变化显著正相关 (P <0 .0 0 1,r =0 .82 7)。cAF组左心室射血分数明显低于SR组 (P <0 .0 5 )。结论 组织醛固酮增加可能参与了心房颤动发生的介导 ,该作用很可能通过促进心房结构重构来实现。
Objective To investigate the mRNA expression of aldosterone synthase (CYP11B2) in atrial myocardium of atrial fibrillation patients. Methods Thirty-eight patients undergoing thoracotomy were hospitalized with heart disease. There were 18 males and 20 females aged 18-77 years old (mean, 5.192 ± 14.0 years). The patients were divided into three groups according to the presence or absence of atrial fibrillation: sinus rhythm group (SR group), 11 cases; paroxysmal atrial fibrillation group (pAF group, duration of atrial fibrillation <6 months), 13 cases; chronic atrial fibrillation group (cAF group, the duration of atrial fibrillation> 6 months, 14 cases of semi-quantitative polymerase chain reaction assay CYP11B2mRNA in atrial muscle tissue expression.Results Compared with SR group and pAF group, cAF group of patients with left atrium (P <0.01), the expression of CYP11B2 mRNA increased significantly (by 81% and 11.8%, P <0.05-0.01, respectively) (P <0.01, r = 0.82 7) .The left ventricular ejection fraction in cAF group was significantly lower than that in SR group (P0.05) .Conclusion Tissue Increased aldosterone may be involved in the occurrence of atrial fibrillation mediated by this effect may be through the promotion of atrial structural remodeling to achieve.