急性心肌梗死患者直接PCI术前后炎性细胞因子动态变化的研究  

Study on Dynamic Changes of Proinflammatory Cytokine in Plasma of AMI Patients before and after Percutaneous Coronary Intervention

作　　者：梁艳媚[1] 林琼申[1] 陈力[2] 

机构地区：[1]广东医学院附属西乡人民医院社康中心,深圳518109 [2]深圳市宝安区人民医院心血管科,深圳518109

出　　处：《中国医药导刊》2011年第4期647-649,共3页Chinese Journal of Medicinal Guide

基　　金：深圳市宝安区科技项目;项目编号:2008199

摘　　要：目的:探讨直接PCI对AMI患者在细胞分子学水平的变化规律,为AMI患者PCI术的预后提供一定的理论依据。方法:采用双抗体夹心ELISA法测定32例健康人(健康组)、36例常规治疗组(对照组)和51例直接PCI术的AMI患者(PCI组)的术前即刻、PCI术后12h、24 h、48 h、72h TNF-α、IL-6、CRP的动态变化。结果:(1)AMI患者血清中炎性细胞因子的浓度较健康人群升高(P<0.05);(2)IL-6和TNF-α的动态变化与术前比较,术后4h无明显升高(P>0.05),12h升高明显(P<0.05),术后24h达峰值(P<0.01),48h后下降,72h后继续下降(P<0.01);CRP的动态变化与术前比较,术后4b明显升高(P<0.05),术后48h达峰值(P<0.01),72h后下降(P<0.05)(3)常规治疗组IL-6、TNF-α.和CRP均与治疗后48h达峰值(P<0.01)。结论:TNF-α、IL-6、CRP均参与了急性心肌梗死病变的发生,PCI术会造成一定程度的炎性反应,但比常规治疗能更快速的降低炎性反应,直接PCI术后的患者血清中TNF-α、IL-6、CRP均有明显的快速达峰后降低。Objective：To observe the dynamic changes of Proinflammatory cytokine in plasma of AMI patients before and after percutaneous coronary intervention.Methods：In 32 healthy men（healthy group） and 87 diagnosed AMI patients[including The control group with conventional treatment（n=36）and the PCI treatment group with percutaneous coronary intervention（n=5 1）],TNF-α and IL-6 in coronary sinus plasma were measured by ELISA,the levels of CRP were measured by nephelometry assay, before PCI,4h,12h,24h,48h and 72h after PCI. Results：（1）PlasmaTNF-α, IL-6,CRPwas significantly higher than that in healthy controls（P〉0.05） before emergency PCI.（2） compared with initial values.the levels of the TNF-α and IL-6 increased statistical significance（P〉0.05） at 12h atter PCI and reach its peak level 24h（P〉0.01） utter PCI,and then gradually decreased.The levels of CRP increased statistical significance（P〉0.05） at 4h utter PCI and reach its peak level（P〉0.01） 48h atter PCI,and then gradually decreased.（3） in the control group,IL-6,TNF-α, and CRP all reach its peak level 48h（P〉0.01） atter treatment. Conelusion：TNF-α, IL-6,CRP be involved in myocardial ischemia-reperfusion injury.PCI may stimulate Inflammation reaction, but PCI can reduce Inflammation reaction more rapidly in comparison with conventional treatmant, TNF-α,IL-6,CRP expression in plasma of AMI patients rose gradually after PCI, and it began to decrease rapidly after reaching the peak.

关 键 词：心肌梗死 直接经皮冠状动脉内介入治疗术 肿瘤坏死因子-Α 白细胞介素-6 C反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]