ACE基因I/D和ACE2基因A9570G多态性与心房颤动的相关性研究

Correlation between polymorphism of ACE gene I/D and ACE2 gene A9570G and atrial fibrillation

目的研究血管紧张素转换酶（ACE）基因I/D和血管紧张素转换酶2（ACE2）基因A9570G多态性与心房颤动（简称房颤）的相关性。方法按入院先后顺序入选305例患者,其中房颤患者148例（房颤组）,基础疾病与房颤患者匹配的非房颤患者157例（对照组）,通过聚合酶链反应-限制性片段长度多态性（PCR-RFLP）和基因测序方法检测两组患者的ACE基因I/Dey ACE2基因A9570G多态性的基因型。结果房颤组ACE基因I/D基因型及等位基因分布与对照组无统计学差异（P=0.841;OR=0.948,95%CI 0.680~1.322,P=0.755）,且不同I/D基因型患者的左房前后径和右房横径大小均无统计学差异（P=0.887,P=0.664）。在男性人群中,ACE2基因A9570G基因型分布与对照组比较无统计学差异（OR=1.631,95%CI 0.880~3.023,P=0.119）,但在男性房颤患者中,G基因型的左房前后径及右房横径（分别为40.1±6.4、40.1±5.7mm）明显大于A基因型患者（分别为37.0±4.4、36.5±4.4mm）,差异有统计学意义（P=0.028,P=0.010）;在女性人群中,ACE2基因A9570G基因型及等位基因分布与对照组比较均无统计学差异（P=0.286;OR=1.415,95%CI 0.885~2.264,P=0.146）,在女性房颤患者中,ACE2基因A9570G不同基因型的左房前后径和右房横径大小均无统计学差异（P=0.924,P=0.432）。结论 ACE基因I/D和ACE2基因A9570G多态性与房颤的相关性均不明显。但在男性房颤患者中,ACE2基因A9570G多态性中G基因型可能是预测心房增大的一个危险因子。

Objective To investigate the correlation between the polymorphism of angiotensin converting enzyme（ACE） gene I/D and angiotensin converting enzyme 2（ACE2） gene A9570G and atrial fibrillation.Methods In chronological order of hospitalization,305 patients were selected and divided into two groups： atrial fibrillation group（148 cases） and control group（157cases without atrial fibrillation）.The control group was matched with the atrial fibrillation group in terms of age,gender,and presence of left ventricular dysfunction,coronary heart disease,diabetes,and primary hypertension.The polymorphisms of the ACE gene I/D and ACE2 gene A9570G were genotyped with polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP） and gene sequencing approach.Results There were no statistical differences between the atrial fibrillation group and the control group in genotype distribution and allele frequencies of the ACE gene I/D（P=0.841;OR=0.948,95% CI 0.680-1.322,P=0.755）.Moreover,there was no significant difference among the different genotypes of ACE gene I/D in the left and right atrial dimensions（P=0.887 and P=0.664,respectively）.In the male subgroup,there was no statistical difference in the ACE2 gene A9570G polymorphism between the two groups（OR=1.631,95% CI 0.880-3.023,P=0.119）.However,in the subgroup of males with atrial fibrillation,the left and right atrial dimensions of subjects with G genotype（40.1±6.4 and 40.1±5.7mm,respectively） were larger than those with A genotype（37.0±4.4 and 36.5±4.4mm,respectively）,indicating a statistical difference（P=0.028,P=0.010）.In the female subgroup,there were no statistical differences between the atrial fibrillation group and the control group in the genotype distribution and allele frequencies of the ACE2 gene A9570G polymorphism（P=0.286;OR=1.415,95% CI 0.885-2.264,P=0.146）.In the subgroup of females with atrial fibrillation,no significant difference was found in the left or right atrial dimension among the different genotypes of ACE2 gene A9570G polymorphism（P=0.924 and P=0.432,respectively）.Conclusions No significant correlation exists between the genotype distribution and allele frequencies of ACE gene I/D and ACE2 gene A9570G polymorphism and atrial fibrillation.However,in males with atrial fibrillation,the G genotype in the ACE2 gene A9570G polymorphism may be a risk factor for the prediction of atrial enlargement.