螺内酯对急性心肌梗死患者血浆可溶性SICAM-1和IL-6及BNP的影响  

Effects of spironolactone on plasma sICAM-1,IL-6 in patients with acute myocardial infarction

作　　者：李侠[1] 董士民[1] 刘坤申[2] 

机构地区：[1]河北医科大学第三医院急诊科,石家庄市050051 [2]河北医科大学第一医院心内科

出　　处：《河北医药》2009年第4期400-401,共2页Hebei Medical Journal

基　　金：河北省科技厅计划课题(编号:052761200)

摘　　要：目的观察螺内酯对急性心肌梗死(AMI)患者血浆可溶性黏附因子-1(sICAM-1)、白介素-6(IL-6)和B型利钠肽(BNP)的影响。方法按有无高血压采用分层随机设计将60例AMI患者分为常规组与螺内酯组,用酶联免疫吸附法(ELISA)测定sICAM-1含量,用放射免疫法测定IL-6含量,用Triage干式快速定量心脏标志物监测BNP含量。结果常规组与螺内酯组第2天sICAM-1分别为(648±153)μg/L、(679±171)μg/L,与我院正常值(189±69)μg/L比较差异有统计学意义(P均<0.01)。螺内酯组第28天sICAM-1含量为(266±98)μg/L,较常规组同时间点含量(355±123)μg/L均显著下降(P均<0.01)。第7天、第28天螺内酯组IL-6含量为(28±10)μg/L、(19±7)μg/L与常规组(39±12)μg/L、(23±9)μg/L比较均显著下降(P均<0.01)。螺内酯组第28天BNP含量为(89±47)ng/L较常规组同时间点含量(123±39)ng/L均显著下降(P均<0.01)。结论螺内酯可降低AMI患者血浆SICAM-1、IL-6和BNP含量,抑制炎症反应,阻抑心室重构。Objective To observe the effects of spironolactone on plasma soluble intereellar adhesion molecule-1 （slCAM-1）, interleukin-6（IL-6） and blood brain natriuretic peptide （BNP） in patients with acute myocardial infarction （AMI）. Methods 60 patients with AMI were randomly divided into two groups according to with or without hypertension. 30 patients in control group were treated by routine therapy, while the other 30 patients in spironolactone group, on the basis of control group, were treated with spironolactone. Plasma sICAM-1, IL-6 and BNP were measured after myocardial infarction. Results The levels of sICAM-1 in control group and spironolactone group were （648 ± 153） μg/L, （679± 171 ） μg/L respectively, which were significantly higher than normal levels （ 19 ± 69）μg/L （ P 〈 0. 01 ）. The levels of slCAM-1 in spironolactone group on the 28th day were （266 ± 98） μ/L, which were significantly lower than those（355 ±123） μg/L of control group（ P 〈 0.01）. The levels of IL-6 in spironolactone group on the 7 th and 28 th day were （28 ±10）μg/L, （ 19±7） μg/L respectively, which were significantly lower than those （39 ± 12） μg/L, （23±9） μg/L in control group（ P 〈 0.01）. The levels of BNP in spironolactone group on the 28th day were （89 ± 47） μg/L, which were significantly lower than those（123 ± 39） μg/L in control group（ P 〈 0.01）.Conclusion The spironolactone can inhibit inflammatory response by decreasing the levels of sICAM-1, IL-6, and can block ventrieular remodeling in patients with AMI.

关 键 词：心肌梗死 螺内酯 血浆可溶性黏附因子-1 白介素6 B型利钠肽 

分 类 号：R542.22[医药卫生—心血管疾病]