缺血后处理对急性心肌梗死患者细胞因子的影响

Effect of ischemic postconditioning on activity of cytokines in patients with acute myocardial infarction

目的:探讨缺血后处理对急性ST段抬高心肌梗死(STEMI)患者细胞因子的影响。方法:急性STEMI患者39例,随机分入对照组(17例)和缺血后处理组(22例)。各例接受急诊冠状动脉介入治疗术(PCI),对照组梗死血管再通后3min内不施加干预;缺血后处理组梗死血管再通后1min内应用低气压充盈和回缩球囊,每一过程各30s,反复3次。PCI术前和术后4h采血测定丙二醛(MDA)、超氧化物歧化酶(SOD),PCI术前和PCI术后12h采血测定肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)。结果:PCI术前2组患者MDA、SOD、TNF-α、IL-6差异无统计学意义,PCI术后缺血后处理组较对照组MDA、TNF-α、IL-6低[分别为(5.53±1.20)∶(6.70±1.24)μmol/L,(33.86±10.08)∶(41.09±11.36)ng/L,(72.07±11.09)∶(79.96±9.25)ng/L,P<0.05]而SOD高[(83.92±13.67)∶(74.31±14.68)U/L,P<0.05]。结论:缺血后处理可以减少急性STEMI患者血清中MDA、TNF-α、IL-6的生成,升高SOD。

Objective：To study the effect of ischemic postconditioning on activity of cytokines in blood of patients with acute myocardial infarction. Method： Thirty-nine patients with acute myocardial infarction underwent primary PCI within 90 minutes after admission and were randomly assigned to control group （n=17） or postconditioning group （n 22）. In the control group, no intervention was given at the onset of reperfusion, while in the postconditioning group, three cycles of 30 seconds of repetitive angioplasty balloon inflation and deflation were performed within 1 minute after reperfusion. MDA, SOD, TNF-α and IL-6 were measured before and after primary PCI. Result：Before primary PCI, serum MDA, SOD, TNF-α and IL-6 were no significant differences between the control group and the posteonditioning group. Serum MDA TNF-α and IL-6 were lower in the postconditioning group than those in the control group after PCI （which were [5.53±1.20]vs [6.70±1.24]μmol/I., [33.86±10.08]vs [41.09±11.36]ng/L, [72.07±11.09]vs [79. 96±9. 25]ng/L, respectively P〈0.05）. Serum SOD was higher in the postconditioning group than that in the control group after PCI （[83.92±13.67] vs [74.31±14.68]U/L, P〈0.05）. Conclusion： Posteonditioning can affect activity of cytokines in blood of patients with acute myocardial infarction.