高血压患者急性心肌梗死后血清炎性因子的变化

Inflammatory Factors in Hypertensive Patients Complicated with Acute Myocardial Infarction

目的探讨高血压患者在心肌梗死后炎性因子的变化及意义。方法急性心肌梗死患者87例根据高血压病史及入院当时血压分为血压正常组(43例)及高血压组(44例),另设健康对照组(25例)。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定各组受试者入院即刻、第24h、第48h、第5天、第7天、第14天血清白介素1β(IL-1β)、白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)含量,健康对照组测1次上述各项指标。结果1)与对照组相比,心肌梗死患者的炎性因子浓度于发病2周内明显升高,呈先升后降的动态变化。2)炎性因子含量除高血压组的血清IL-6第5天(P=0.019)至第7天(P=0.005)的数值较血压正常组有明显升高外,其他数值两组无明显差异。结论炎症参与了急性心肌梗死全过程,在急性心肌梗死早期的炎性反应中,高血压对部分炎性因子起到了一定的促进作用。

Objective To investigate the alteration and significance of inflammatory factors in hypertension patients complicated with acute myocardial infarction（AMI）. Methods Eighty seven AMI patients were grouped as normotensive group（n=43） or hypertensive group（n=44）, 25 healthy subjects served as control. Plasma level of IL-1β, IL-6, IL-8, TNF-α and IFN-γ were determined at admission of hospitalization, 24 h, 48 h, 5 d, 7 d and 14 d after myocardial infarction using ELISA method. Results 1 ）Compared with the control group, the level of all inflammatory markers were elevated significantly in 2 weeks after myocardial infarction and showed a pattern of dynamic changes. 2 ）Compared with normotensive group, IL-6 in hypertensive group was increased more significantly on 5th day（P=0. 019） to 7th day（P=0. 005）after AMI. Conclusion Inflammation was involved in the course of AMI since the early stage. Hypertension seems to exaggerated the inflammatory reaction after myocardial infarction.