白细胞介素-17与急性心肌梗死患者经皮冠状动脉介入术后心肌无复流发生的相关性研究  

Relationship between interleukin-17 and myocardial no-reflow after percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：鲁志科[1] LU Zhi-ke(Department of Cardiology,the Xiaogan City Center Hospital,Xiaogan 432000,Chin)

机构地区：[1]孝感市中心医院心内科

出　　处：《中国心血管病研究》2018年第7期609-612,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨白细胞介素-17（interleukin-17,IL-17）与急性心肌梗死患者经皮冠状动脉介入术后心肌无复流发生的相关性.方法 选取2016年1月至2017年7月在我院接受经皮冠状动脉介入术治疗的90例急性心肌梗死患者为研究对象,采用ELISA法检测患者血清中IL-17水平,监测患者入院时及术后lh的心电图,并计算ST段回降幅度.根据经皮冠状动脉介入术中心肌梗死溶栓试验（TIMI）血流分级,将患者分为无复流组（TIMI血流分级≤Ⅱ级）和再灌注组（TIMI血流分级＞Ⅱ级）,分别为29例和61例.结果 无复流组患者术后24 h及48 h血清IL-17水平分别为（76.05± 17.62）pg/ml及（114.82±34.69）pg/ml,均明显高于再灌注组的（51.74±15.98）pg/ml及（47.53±13.47）pg/ml（P均＜0.05）,且无复流组术后48 h血清IL-17水平明显高于术后24 h水平（P＜0.05）,而再灌注组术后48 h血清IL-17水平低于术后24 h水平（P＞0.05）;无复流组中心电图ST段迅速回降（STR≥50％）的病例数（7例）明显少于再灌注组（49例）,且差异有统计学意义（P＜0.05）;血清IL-17水平及患者发病至血管再通时间是影响心肌无复流发生的独立危险因素（P＜0.05）.结论 IL-17与急性心肌梗死患者经皮冠状动脉介入术后心肌无复流的发生密切相关,患者介入术后IL-17水平,尤其是术后48 h水平,可作为诊断心肌无复流的一个评价指标.Objective To investigate the correlation between interleukin-17 and myocardial no-reflow after percutaneous coronary intervention in patients with acute myocardial infarction. Methods A total of 90 patients with acute myocardial infarction who underwent pereutaneous coronary intervention in our hospital from January 2016 to July 2017 were selected as subjects, serum levels of interleukin-17 were measured by ELISA, and the electrocardiogram was monitored at one hour postoperatively and the ST-segment amplitude was calculated. The patients were divided into no-reflow group （TIMI blood flow grade ≤ Ⅱ grade） and reperfusion group （TIM1 blood flow grade 〉 Ⅱ grade ） according to the myocardial infarction thrombolytic test（ TIMI ） of percutaneous coronary intervention, 29 cases and 61 cases. Results The serum IL-17 levels at 24 h and 48 h in the no-reflow group were （ 76.05± 17.62 ） pg/ml and （ 114.82±34.69 ） pg/ml, which were significantly higher than those in the reperfusion group（51.74±15.98）pg/ml and（47.53±13.47）pg/ml（P〈0.05 ）, and the serum interleukin-17 level was significantly higher than that of the untreated group （P〈0.05）.The number of cases in the ST segment of the electrocardiogram （STR≥50%） without re-flow group （7 cases） was significantly lower than that of the reperfnsion group （49 cases） , and the difference was statistically significant （P〈0.05）. The level of serum interleukin-17 and the time of onset to recanalization were independent risk factors of myocardial reflow （P〈0.05）. Conclusion Interleukin-17 is associated with the occurrence of no-reflow in myocardium after percutaneous coronary intervention in patients with acute myocardial infarction. The level of interleukin-17, especially at 48 h after intervention, can be used as an evaluation of myocardial reflow index.

关 键 词：白细胞介素-17 急性心肌梗死 经皮冠状动脉介入术 心肌无复流 相关性 

分 类 号：R542.22[医药卫生—心血管疾病]