吸烟对急性心肌梗死患者静脉溶栓再通前后炎性因子表达的影响  

Effect of cigarette smoking on expression of inflammatory cytokines in acute myocardial infarction after successful thrombolysis

作　　者：陈治国[1] 檀立端[1] 程瑞年[1] 陈慧君[2] 

机构地区：[1]承德市中心医院急诊科,河北承德067000 [2]承德市中心医院皮肤科

出　　处：《临床心血管病杂志》2013年第6期423-425,共3页Journal of Clinical Cardiology

基　　金：承德市科技技术研究与发展计划项目(No:201121005)

摘　　要：目的:研究吸烟对急性心肌梗死(AMI)患者静脉溶栓前及再通后血清白细胞介素(IL)-1、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α和IL-10表达水平的影响,探讨其对缺血再灌注损伤(MIRI)的影响机制。方法:根据患者吸烟状态将患者分为吸烟组和不吸烟组,静脉溶栓采用重组链激酶,分别于溶栓治疗前及溶栓治疗再通后12h、24h采集静脉血,双抗体夹心ABC-ELISA法测定IL-1与IL-10,放射免疫分析测定TNF-α,速率散热比浊法测定hs-CRP。结果:吸烟组溶栓前、溶栓再通后12h和溶栓再通后24h4种炎性因子的表达水平均显著高于不吸烟组(均P<0.01);吸烟组溶栓再通后12h和24h4种炎性因子表达水平均高于溶栓前(均P<0.01),且溶栓再通后24h表达水平高于溶栓再通后12h(P<0.01);不吸烟组溶栓再通后12h和24h4种炎性因子表达水平均高于溶栓前(均P<0.01),但溶栓再通后12h和24h表达水平差异无统计学意义。结论:吸烟可显著上调AMI患者溶栓前、溶栓再通后12h和24h内IL-1、TNF-α、hs-CRP和IL-10的表达,加重MIRI,且在溶栓再通后24h内损伤持续加重。Objective：To clarify the effect of cigarette smoking on the expression levels of serum IL-1, hs-CRP, TNF-α and IL-10 in patients with acute myocardial infarction （AMI） before and after successful thrombolysis, and to explore the mechanism of the effect of cigarette smoking on the myocardial ischemia reperfusion injury （MIRI）. Method：According to the smoking status, the AMI patients were divided into two groups, non smoking group and smoking group. All the patients were treated with recombinant streptokinase. The serum samples were collected before and after thrombolytic therapy at 12th hours and 24th hours respectively. Double antibody sandwich ABC ELISA was used to detect the expression levels of IL-1 and IL-10, the serum TNF-α and hs-CRP were measured by radioimmunoassay and rate nephelometry. Result：The serum levels of IL-1, hs-CRP, TNF-α and IL-10 of smoking group before and after intravenous thrombolysis reperfusion at 12th hours and 24th hours were all higher than those in non-smoking group （all P〈0.01）. The four inflammatory cytokines levels after successful thrombosis at 12th hours and 24th hours were significantly higher than those before thrombolysis therapy （all P〈0.01）, both in smoking group and non-smoking group. The four inflammatory cytokines levels after successful thrombosis at 12th hours and 24th hours had no statistical difference in non smoking group. Conclusion：Smoking can increase the levels of serum IL-1, hs-CRP, TNF-α and IL-10 in patients with AMI berore and after intravenous thrombolysis reperfusion, which caused the MIRI heavily, and it continued to increase the injury.

关 键 词：心肌梗死 急性 溶栓再通 炎性因子 

分 类 号：R542.2[医药卫生—心血管疾病]