急性心肌梗死患者经皮冠状动脉介入治疗术后慢血流发生与梗死相关动脉病变局部白细胞介素-6水平的关系  

Association Between Local Interleukin-6 Levels and Slow Flow in Patients With Acute Myocardial Infarction Undergone PCI

作　　者：董梅[1] 任法新[1] 牟楠[2] 张传焕[1] 李建平[1] 陶志刚[1] 杨军[1] 

机构地区：[1]烟台毓璜顶医院心内科,山东省烟台市264000 [2]烟台毓璜顶医院妇科,山东省烟台市264000

出　　处：《中国循环杂志》2014年第3期185-188,共4页Chinese Circulation Journal

基　　金：烟台市科技发展计划(批准编号:2013WS221)

摘　　要：目的:探讨ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后慢血流发生风险与梗死相关动脉管病变局部白细胞介素-6(IL-6)水平的关系。方法:共纳入STEMI行急诊PCI的患者56例,其中男性34例,女性22例,平均年龄(63.5±10.3)岁。PCI术前应用6F Diver CE抽吸导管在导丝支持下,于冠状动脉病变的远端局部取样,采用酶联免疫吸附法测定IL-6水平。结果:共计21例(37.5%)患者发生慢血流。多因素Logistic回归分析表明糖尿病(OR=0.124,95%CI:0.019-0.804,P=0.029)、血栓负荷评分(OR=0.080,95%CI:0.007-0.909,P=0.042)、局部IL-6(OR=0.623,95%CI:0.441-0.881,P=0.007)是慢血流发生的独立危险因素。ROC曲线表明局部IL-6(ROC面积0.824,OR=1.704,95%CI:1.274-2.281,P=0.001;理想阈值:≥11.3pg/ml)对慢血流的发生具有重要预测价值(敏感性为73%,特异性为71%)。结论 :梗死相关动脉病变局部IL-6水平升高与STEMI患者行急诊PCI术后慢血流的发生密切相关。Objective： We aimed to investigate the association between local interleukin-6 （IL-6） levels at the infarct-related artery and the risk of slow flow after PCI in ST segment elevation myocardial infarction （STEMI） patients treated by successful primary PCI. Methods： 56 eligible STEMI patients （34 male/22 female, mean age： 63.5±10.3 years）, undergoing successfully primary PCI, were included in the current study. Blood samples were obtained from the extraction catheter placed distal to the lesion before PCI. Plasma IL-6 levels were determined by immunoassay method. Results： Slow flow was observed in 21 patients （37.5%）. Using multiple logistic regression analysis, local IL-6 levels （OR=0.623, 95%CI 0.441-0.881, P=0.007） were found to be a significant risk factor of slow flow together with diabetes mellitus （OR=0.124, 95%CI 0.019-0.804, P=0.029） and thrombus score （OR=0.080, 95%CI 0.007-0.909, P=0.042）. Receiver operating characteristic （ROC） curve analysis revealed that local IL-6 （ROC area 0.824, OR=1.704, 95%CI 1.274-2.281, P=0.001 and optimal threshold≥11.3 pg/ml） had a predictive value of slow flow with sensitivity of 73% and specificity of 71%. Conclusion： Our study indicated that inflammatory response as presented by local IL-6 levels was associated with slow flow in patients with STEMI after successfully primary PCI.

关 键 词：白细胞介素-6 慢血流 炎症反应 急性心肌梗塞 

分 类 号：R54[医药卫生—心血管疾病]