急性心肌梗死急诊PCI后血浆TNF-a和IL-6的水平  

The Plasma Level of TNF-A and IL-6 in Acute Myocardial Infarction Patient with Emergency Primary Percutaneous Coronary Intervention

作　　者：于丽平[1] 范谦[1] 刘霖[1] 刘胜辉[1] 杨新春[1] 

机构地区：[1]首都医科大学附属北京朝阳医院心脏中心,北京100020

出　　处：《中国医药导刊》2012年第10期1668-1669,1671,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:观察急性心肌梗死(AMI)患者的梗死相关血管开通后血浆TNF-a和IL-6的水平。方法:采用ELISA法测定46例AMI患者急诊冠脉介入治疗(PCI)前即刻、术后24h、72h血浆TNF-a和IL-6的水平。所有患者均为LAD近中段单支病变,梗死相关血管完全闭塞。结果:与PCI前相比,PCI术后TNF-a和IL-6均升高,TNF-a持续升高,IL-6的高峰期在PCI后12～24小时,根据cTnI的水平分为两组,cTnI>3ng/ml为高cTnI组,cTnI<3ng/ml为低cTnI组。高cTnI组与cTnI组相比PCI术后24小时IL-6、TNF-a升高更明显(P<0.05),PCI术后72小时,两组无统计学差异。结论:心肌损伤程度直接决定了心肌梗死患者再灌注早期血浆中炎症介质的水平。Objective：To explore the plasma level of TNF-a and IL-6 in acute myocardial infarction（AMI） patient with percutaneous transluminal coronary intervention（PCI）.Methods：The plasma level of TNF-a and IL-6 was tested by enzyme linked immunosorbent assay（ELISA assay） before emergency PCI,24~72 hours.All the patients were single coronary vessel disease,and all the lesions were totally occluded in proximal or middle of LAD.Results：The serum concentrations of IL-6 and TNF-a after PCI were elevated in all patients with AMI when compared with before PCI（P0.05）The level of TNF-a has been constantly rising.The peak hour of the level of IL-6 is around from 12 to 24 hours after PCI.Two groups were distinguished according to the level of cTnI,high-cTnI group was cTnI3 ng/ml and lowcTnI group was cTnI3ng/ml.In both groups,the levels of IL-6 and TNF-a increased 24 hours after primary PCI,and it was more significant in high-cTnI group than in low-cTnI group（P0.05）,but 3 days after PCI,this difference got no significant.Conclusion：The plasma level of mediators of inflammation in early phase of reperfusion in AMI was directly determined by the extent of myocardial damage.

关 键 词：心肌梗死 心肌再灌注 白细胞介素6 肿瘤坏死因子A 

分 类 号：R542.22[医药卫生—心血管疾病]