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目的 了解不同程度充血性心力衰竭 (CHF)病人心肌细胞血管紧张素Ⅱ型受体 (AT1)、AT2 的mRNA表达与心肌重塑和心功能的关系。方法 通过手术取材 ,采用RT PCR技术测定 31例瓣膜病所致CHF病人不同心功能组与 5例正常人心肌细胞AT1和AT2 的mRNA表达。结果 瓣膜病所致心力衰竭 (心衰 )病人心肌组织呈心肌重塑的病理改变。轻度心衰病人心肌细胞AT1mRNA表达较正常人增高 ,中重度心衰组AT1mRNA表达明显降低 ,AT2 mRNA表达差异无显著性 ,但AT1/AT2 比值明显降低。结论 心肌细胞AT1在轻度心衰病人增高可能与心肌肥厚的发生有关 ,重度心衰病人心肌细胞占优势的受体亚型从AT1转变为AT2 ,其功能意义可能是对心衰的局部保护机制 ,也可能通过AT2 诱导心肌细胞凋亡 ,致心功能进一步恶化
Objective To investigate the relationship between the expression of angiotensin Ⅱ type 1 receptor (AT1) and AT2 mRNA and myocardial remodeling and cardiac function in patients with congestive heart failure (CHF). Methods The mRNA expression of AT1 and AT2 in different cardiac function groups and 5 normal human cardiomyocytes from 31 patients with valvular heart disease were measured by RT-PCR. Results Heart disease patients with valvular heart disease (CHF) showed myocardial pathological changes in myocardial remodeling. The expression of AT1mRNA in cardiomyocytes of mild heart failure patients was higher than that in normal people. The expression of AT1mRNA in moderate and severe heart failure group was significantly decreased. There was no significant difference in AT2mRNA expression, but the AT1 / AT2 ratio was significantly decreased. Conclusions The increase of myocardial AT1 in patients with mild heart failure may be related to the occurrence of cardiac hypertrophy. The receptor subtypes predominant in cardiomyocytes of patients with severe heart failure change from AT1 to AT2, and its functional significance may be the local protection mechanism of heart failure , May also induce cardiac myocyte apoptosis through AT2, resulting in further deterioration of cardiac function