风心二狭房颤患者心房组织的HCN4基因表达及动作电位的研究  

THE EXPRESSION OF HCN4 GENE AND ACTION POTENTIAL IN ATRIAL FIBRILLATION PATIENTS WITH MITRAL STENOSIS OF RHEUMATIC HEART DISEASE

作　　者：钱俊[1] 周华富[1] 杨涛[1] 赵超仁[1] 冯旭[1] 

机构地区：[1]广西医科大学第一附属医院心胸外科,南宁530021

出　　处：《广西医科大学学报》2012年第1期52-54,共3页Journal of Guangxi Medical University

基　　金：广西科学基金资助项目(桂科攻0816004-24)

摘　　要：目的:通过分析风湿性心脏病二尖瓣狭窄(风心二狭)患者心房肌组织HCN4基因表达及动作电位与心房颤动发生的关系,为风心二狭房颤发生机制的研究提供理论依据。方法:取手术患者心耳组织100mg,提取RNA后应用半定量逆转录-PCR方法检测mRNA含量,并对PCR产物测序分析;以HCN4基因mRNA和内参β-actin含量的比值作为评价HCN4基因mRNA表达水平指标;采用急性分离心肌细胞的方法将其分为MS房颤(atrial fibrillation,AF)组和窦律(Sinus rhythm,SR)组,记录两组的动作电位(AP),观察两组心肌细胞动作电位时程(APD)的改变。结果:风心二狭房颤组及对照组HCN4基因mRNA与β-actin含量的相对表达值比值分别为0.696±0.257和0.125±0.010,两组比较,差异有统计学意义(P<0.01)。房颤病人心房肌APD、APD复极至50%的时程(APD50)及APD复极至90%的时程(APD90)较窦性心律组明显缩短,差异有统计学意义(P<0.05)。结论:房颤心肌细胞HCN4基因的过度转录表达及APD缩短可能共同参与了调控风心二狭房颤的发生过程,揭示了风心二狭房颤发生的分子机制及电流学机制。Objective： To analyze the relationship of myocardial HCN4 gene expression and action potential and the mechanism of atrial fibrillation in patients with mitral stenosis of rheumatic heart disease.Methods： The atrial mRNA expression of HCN4 gene was detected by semi-quantitative reverse transcription-PCR（RT-PCR） in two groups： atrial fibrillation（38 patients） and without atrial fibrillation（14 patients）,then the sequence of PCR products of HCN4 gene was analyzed.The ratio of starting quantity of HCN4 gene and house-keeping gene β-actin was used as the evaluation of HCN4 gene mRNA expression.Human atrial myocytes were divided into atrial fibrillation and sinus rhythm groups by acute separation method.The difference in the action potential was compared between the two groups.Results： The relative expression of HCN4 gene mRNA in experimental and control groups is 0.696±0.257 and 0.125±0.010（P0.01）;respectively.APD,action potential at 50% and 90% of repolarization（APD50,APD90） were significantly shorter than those in controls（P0.05）.Conclusion： The overexpression of HCN4 gene and cut down of APD might participate in the progress of atrial fibrillation development in mitral stenosis of rheumatic heart disease,which reveals the molecular and ion channels mechanism.

关 键 词：HCN4基因 风湿性心脏病二尖瓣狭窄 心房纤颤 动作电位 

分 类 号：R541.2[医药卫生—心血管疾病] R540.4[医药卫生—内科学]