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目的研究氯通道ClC-1和ClC-2基因在人心房组织的表达及与心房颤动(AF)的关系。方法将71例风湿性心瓣膜病接受换瓣手术患者分为三组,窦性心律(SR)组31例,阵发性房颤(PAF)组7例,慢性房颤(CAF)组33例,于术中获取右心耳组织,应用半定量逆转录-聚合酶链反应(RT-PCR)检测心房组织ClC-1和ClC-2的mR-NA相对含量。结果①ClC-1、ClC-2基因在人心房组织有表达。②与SR组比较,PAF组ClC-1的mRNA表达增加但无统计学意义(1.05±0.22vs1.01±0.13,P>0.05),CAF组的表达明显增加(1.25±0.18vs1.01±0.13,P<0.001),CAF组较PAF组亦明显增加(P<0.01)。ClC-1的mRNA表达水平与左房内径、AF持续时间呈正相关[(r=0.344,P=0.003)(r=0.405,P<0.001)]。③与SR组比较,PAF组ClC-2的mRNA表达无增加(1.03±0.14vs1.04±0.15,P>0.05),CAF组的表达明显增加(1.26±0.13vs1.04±0.15,P<0.001),CAF组较PAF组亦明显增加(P<0.01)。ClC-2的mRNA表达与左房内径、AF持续时间呈正相关[(r=0.441,P<0.001)(r=0.331,P=0.005)]。结论AF患者ClC-1、ClC-2的mRNA表达水平的增加可能是心房肌电重构的分子基础。
Objective To study the expression of ClC-1 and ClC-2 genes in human atria and their relationship with atrial fibrillation (AF). Methods Thirty-seven patients with rheumatic valvular heart disease undergoing valve replacement surgery were divided into three groups: 31 patients in sinus rhythm group (SR), 7 patients in paroxysmal atrial fibrillation (PAF) group and 33 patients in chronic atrial fibrillation (CAF) group The right atrial appendage was obtained during surgery. The relative content of mR-NA in atrial tissue ClC-1 and ClC-2 was detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results ①CCl-1 and ClC-2 genes were expressed in human atria. ②Compared with SR group, the expression of ClC-1 mRNA increased in PAF group (1.05 ± 0.22vs1.01 ± 0.13, P> 0.05), while the expression in CAF group was significantly increased (1.25 ± 0.18vs1.01 ± 0.13 , P <0.001), CAF group also significantly increased compared with PAF group (P <0.01). ClC-1 mRNA expression was positively correlated with left atrial diameter and AF duration (r = 0.344, P = 0.003) (r = 0.405, P <0.001). ③Compared with SR group, the expression of ClC-2 mRNA in PAF group was not increased (1.03 ± 0.14vs1.04 ± 0.15, P> 0.05), and the expression of ClC-2 in CAF group was significantly increased (1.26 ± 0.13vs1.04 ± 0.15, P <0.001) ), CAF group also significantly increased compared with PAF group (P <0.01). ClC-2 mRNA expression was positively correlated with left atrial diameter and AF duration (r = 0.441, P <0.001) (r = 0.331, P = 0.005). Conclusions The increase of mRNA expression of ClC-1 and ClC-2 in patients with AF may be the molecular basis of atrial remodeling.