戒烟时间对急性心肌梗死溶栓再通前后炎性因子的影响研究  

Smoking Cessation Time Influencing Expression of Inflammatory Cytokines in AMI Patient before and after Thrombolytic Recanalization

作　　者：陈治国[1] 檀立端[1] 于海霞[1] 陈慧君[1] 

机构地区：[1]河北省承德市中心医院急诊科,067000

出　　处：《中国全科医学》2013年第14期1596-1598,共3页Chinese General Practice

基　　金：承德市科学技术研究与发展计划项目(201121005)

摘　　要：目的探讨不同戒烟时间对急性心肌梗死(AMI)患者溶栓前和溶栓再通后血清白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)和白介素-10(IL-10)水平的影响。方法选择2010年7月—2011年12月承德市中心医院急诊科收治的AMI患者60例,根据患者吸烟状态将患者分为不吸烟组、戒烟时间<5年组和戒烟时间≥5年组。采用重组链激酶进行静脉溶栓,分别于溶栓前、溶栓再通后12 h和24 h采集静脉血,采用双抗体夹心ABC-ELISA法测定IL-1、IL-10,放射免疫法测定TNF-α。结果 3组患者溶栓前、溶栓再通后12 h和24 h时TNF-α、IL-1和IL-10水平差异均有统计学意义(P<0.05)。组间比较,戒烟时间<5年组患者溶栓前、溶栓再通后12 h和24 h时TNF-α、IL-1和IL-10水平较不吸烟组和戒烟时间≥5年组患者明显升高,差异有统计学意义(P<0.001),不吸烟组和戒烟时间≥5年组患者以上指标间差异无统计学意义(P>0.05)。组内比较,溶栓再通后12 h和24 h时TNF-α、IL-1和IL-10水平均较溶栓前明显升高,差异有统计学意义(P<0.001);戒烟时间<5年组再通后24 h时TNF-α、IL-1和IL-10水平较再通后12 h时明显升高,差异有统计学意义(P<0.001),不吸烟组和戒烟时间≥5年组再通后24 h和再通后12 h时以上指标间差异均无统计学意义(P>0.05)。结论戒烟时间能影响AMI患者溶栓前、溶栓再通后炎性因子的表达,戒烟时间≥5年AMI患者炎性因子的表达水平明显下调,心肌缺血再灌注损伤基本等同于不吸烟者。Objective To explore the effects of smoking cessation time on expressions of serum IL - 1, TNF - α and IL - 10 in patients with acute myocardial infarction （AMI） before and after thrombolytic recanalization. Methods Sixty AMI pa- tients admitted to Chengde Central Hospital from July 2010 to December 2011 were divided, based on their smoking information, into Groups A （nonsmoking）, B （cessation time 〈 5 years）, C （cessation time 5 years）. Recombinant streptokinase was used to perform intravenous thrombolysis. Venous blood was collected before thrombolysis, at hours 12, 24 after, to detect IL - 1, IL - 10 by double - antibody sandwich ABC - ELISA method, TNF - α by radioimmunoassay. Results There was signifi- cant difference in TNF -α, IL - 1, IL - 10 between 3 groups before thrombolysis and at hours 12, 24 after （P 〈0. 05） ; Group B had higher levels than groups A, C （P 〈0. 001） ; No difference was noted between groups A and C （P 〉0.05）. The levels of TNF - α, IL - 1, IL - 10 were significantly higher at hours 12, 24 after thrombolysis than before in 5 groups （P 〈0. 001 ）, higher at hour 24 than at hour 12 after thrombolysis in group B （ P 〈0. 001 ） , but there was no difference between groups A and C （ P 〉 0.05）. Conclusion The time of smoking cessation affects the inflammatory cytokines expression in AMI patients before and after thrombolytic therapy. Patients having stopped smoking 5 years or more have lower inflammatory cytokines expression, their myocardial ischemia - reperfusion injuries are basically the same as those of non - smokers.

关 键 词：戒烟 急性心肌梗死 溶栓再通 肿瘤坏死因子-Α 白介素-1 白介素-10 

分 类 号：R542.22[医药卫生—心血管疾病]