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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 relationship between angiotensin converting enzyme (ACE) gene I / D and angiotensin converting enzyme 2 (ACE2) gene A9570G polymorphism and atrial fibrillation (atrial fibrillation). Methods According to the order of hospital admission, 305 patients were enrolled, including 148 patients with atrial fibrillation (AF), 157 patients with non-AF (AF) matched with patients with atrial fibrillation and control subjects. The patients were followed up by polymerase chain reaction The genotypes of A9570G polymorphism of ACE gene I / Dey ACE2 gene in both groups were detected by PCR-RFLP and gene sequencing. Results There was no significant difference in ACE gene I / D genotype and allele distribution between the two groups (P = 0.841; OR = 0.948, 95% CI 0.680-1.332, P = 0.755) There was no significant difference in the size of the left and right atrium before and after surgery (P = 0.887, P = 0.664). In the male population, there was no significant difference in the distribution of ACE2 A9570G genotype between the two groups (OR = 1.631, 95% CI 0.880-3.023, P = 0.119) The anteroposterior diameter and right atrial diameter (40.1 ± 6.4, 40.1 ± 5.7mm, respectively) were significantly higher than those in A genotype (37.0 ± 4.4,36.5 ± 4.4mm, respectively), the difference was statistically significant (P = 0.028, P = 0.010). There was no significant difference in the genotype and allele distribution of ACE2 A9570G among the female population (P = 0.286; OR = 1.415, 95% CI 0.885-2.264, P = 0.146) In patients with atrial fibrillation, there were no significant differences in the left and right atrial diameters between the two genotypes of ACE2 A9570G (P = 0.924, P = 0.432). Conclusion There is no significant correlation between ACE gene A9570G polymorphism and ACE gene ACE gene I / D and atrial fibrillation. However, genotype G of ACE2 A9570G polymorphism may be a risk factor for predicting atrial enlargement in male AF patients.