急性心肌梗死再灌注中血浆白细胞介素8、肿瘤坏死因子α的动态变化及意义  

The Change and Clinical Significance of Plasma lnterleukin-8 and Tumor Necrosis Factor during Myocardial Infarction Reperfusion in Acute Myocardial Infarction

作　　者：杜卫京[1] 任美书[1] 冯淑芝[1] 肖广辉[1] 陈珺[2] 姚朱华[2] 钟述猷[3] 

机构地区：[1]天津医科大学总医院老年病科,300052 [2]天津医科大学总医院心内科,300052 [3]天津医科大学总医院免疫科,300052

出　　处：《天津医药》2001年第6期341-343,共3页Tianjin Medical Journal

摘　　要：目的:探讨急性心肌梗死(AMI)心肌缺血再灌注过程中血浆白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)的动态变化及其意义。方法:采用单抗夹心ELISA方法,观察比较27例经链激酶(SK)或重组组织型纤溶酶原激活剂(rt-PA),溶栓治疗的AMI患者溶栓前,溶栓后2h、4h、8h、10h、12h血浆IL-8和TNF-α动态变化,并进行统计学分析。结果:27例观察组AMI患者中,14例溶栓治疗后相关血管再通者(再通组),13例溶栓治疗相关血管未通者(未通组),再通组IL-8、TNF-α各时间点与正常对照组间有显著差异(F=51.474、F=21.322,均P<0.01),未通组IL-8、TNF-α各时间点与正常对照组间有显著差异(F=43.694、F=36.45,均P<0.01)。再通组与未通组IL-8比较2h、4h(t=7.652、t=3.054,均P<0.01)有显著性差异,再通组与未通组TNF-α比较2h,4h(t=1.667、t=19.389),(P<0.05和P<0.01)也有显著性差异。两组溶栓治疗前IL-8、TNF-α比较(q=2.498、q=0.326,均P>0.05)无显著性差异。结论:IL-8、TNF-α在心肌缺血再灌注后炎症损伤中起关键作用,监测IL-8,TNF-α动态变化有助于临床对AMI再灌注损伤的认识,对防治AMI再灌注后炎症损伤的认识,对防治AMI再灌注后炎症损伤有一定实用价值。Objective:To study the changes and clinical significance of plasma interleukin-8 (IL-8) and tumor necrosis factor (TNF-α) during myocardial infarction reperfusion in acute myocardial infarction (AMI). Methods: Plasma IL-8 and TNF-α were measured with ELISA in 27 patients with AMI who received the treatment of SK, rt-PA(retissue-type plasminogen activator), and thrombolysis at admission and 2,4,6,8,10, and 12 hours after therapy. Results: Fourteen patients developed reperfusion(reperfusion group) and 13 did not (non-reperfusion group). There was a significant difference in plasma IL-8 and TNF-αbetween reperfusion, non-reperfusion and control groups (P<0.01). There was a significant difference in plasma IL-8 and TNF-α between reperfusion and non-reperfusion groups( P < 0.01), and there was no significant difference in plasma IL-8 and TNF-α between reperfusion and non-reperfusion groups before the treatment of thrombolysis (P > 0.05). Conclusion: IL-8 and TNF-α play a critical role in myocardial ischemia after reperfusion inflammatory injury. Monitoring the changes of plasma IL-8 and TNF-α will be helpful to recognize myocardial ischemia reperfusion injury. These may be useful in reducing myocardial infarction after reperfusion inflammatory injury.

关 键 词：急性心肌梗死 再灌注损伤 血浆 白细胞介素8 肿瘤坏死因子Α 

分 类 号：R542.22[医药卫生—心血管疾病]