急性心肌梗塞发生中肿瘤坏死因子的作用探讨

The Role of Tumor Necrosis Factor-alpha (TNF_α) in Acute Myocardial Infarction

本文观察了22例AMI患者及免心便模型血浆中TNF的含量变化，以研究TNF对心肌梗塞坏死面积的影响。结果发现：（1）AMI患者心肌梗塞早期血浆TNFα迅速升高，高峰在胸痛发作后4小时，显著高于正常对照组（P＜0．001），以后逐渐下降，48小时与正常对照组比较无差异（P＞0．05）。（2）在免心梗模型中，用TNF单克隆抗体中和血浆中的TNF后，坏死区占缺血区和坏死区占左心室的体积百分比ATM组显著低于AMI组（P＜0．01）。提示：TNFα在AMI发生中起重要作用，TNFα单克隆抗体可显著减少心肌梗塞范围。

Plasma TNFα levels in 22 patients with AMI were observed, and the effects of TNFα on the necrostic area of myocardium in rabbits with experimental myocardial infarction wer investigated. The results showed:(1) plasma TNFα levels were remarkably increased, which were higher in the early stages of acute myocardial infarction than that in controls (P< 0. 01). TNFα peak value was at 4 hours after onset of chest pain, then decreasedgradually. There was no difference between patients with AMI at 48 hours after onset of chest pain and the controlos(P>0. 05). (2) Anaeshised open chest rabbit model of myocardial infarction was employed to demonstrate the effects of special antibody of TNFα on the size of myocardial necrosis. The ratio of size of necrosis and of ischemia wassignificantly in ATM group than in AMI group (P< 0. 01). The results suggested that TNFα played an importantrole in the pathogenesis of AMI; monoclonal antibody of TNFα might significantly reduce the infarcted size.