急性心肌梗死病人溶栓时IL-6浓度的动态变化及临床意义

DYNAMIC CHANGES OF INTERLEUKIN 6 IN PATIENTS WITH ACUTE MYOCARDIAL INFARTION RECEIVING THROMBOLYSIS THERPY

①目的 了解白细胞介素－６（ＩＬ－６）在急性心肌梗死（ＡＭＩ）溶栓与非溶栓时的浓度变化，探讨其在ＡＭＩ发病过程中的作用。②方法 选择３０ 例发病１２ｈ 内入院的ＡＭＩ病人，其中１３ 例于发病后１２ｈ 溶栓成功，８ 例溶栓未通，９ 例未予溶栓治疗，用酶联免疫吸附法（ＥＬＩＳＡ）测定ＡＭＩ病人发病后１２，２４，４８，７２ 及１２０ｈ 时的ＩＬ－６浓度，并与１５例健康人进行比较。入院后２８ｄ 行多普勒检查测定左室射血分数（ＬＶＥＦ）。③结果 ３０ 例ＡＭＩ病人发病后１２，２４，４８，７２ 及１２０ｈ 的ＩＬ－６ 浓度均增高，与对照组相比较差异均有极显著意义（ｔ＝ ４．２０～６．２８，Ｐ 均＜０．０１），溶栓再通组１２，４８ｈ 时ＩＬ－６ 浓度与溶栓未通组和未溶栓组比较差异有极显著性（ｔ＝ ３．４２～４．７１，Ｐ＜ ０．０１）。ＩＬ－６ 浓度峰值与肌酸磷酸激酶（ＣＰＫ）、ＬＶＥＦ无相关性（ｒ＝ ０．２１，－ ０．３１，Ｐ＞ ０．０５）。④结论 ＩＬ－６ 参与ＡＭＩ发病和心肌缺血－再灌注的过程，检测ＩＬ－６ 浓度对判断冠状动脉是否再通有一定作用。

Objective\ To investigate the dynamic changes of interleukin 6( IL 6) in patients with acute myocardial infartion(AMI) receiving thrombolysis therapy and their clinical significance.\ Methods\ 30 AMI patients were hospitalized 12 hours after onset of symptoms, of which 13 cases received successful thrombolysis within 12 hours, 8 cases failad in thrombolytic treatment and 9 cases didn't receive thrombolytic treatment. Enzyme linked immunosorbent assay(ELISA) was used to measure the concentration of IL 6 of AMI patients at 12h, 24h, 48h,3d and 5d after onset of symptoms and compared with that of 15 normal controls. Left ventricular eject fraction(LVEF) was recorded by Doppler examination in all cases 28 days after admission. Results\ The concentrations of IL 6 at 12h,24h,48h,3d, 5d after symptoms were significantly higher than those of control group ( t=4.20-6.28, P <0.01) . In successful thrombolysis group, the IL 6 values at 12h and 48h were significantly different from that of the unsuccessful thrombolysis group and no thrombolysis group( t=3.42-4.71,P <0.01). No correlations were found between IL 6 peak values and CPK,LVEF( r=0.21,-0.31,P >0.05).\ Conclusion\ IL 6 might be involved in the course of AMI and ischemic reperfusion. Determination of IL 6 level could help with the diagnosis of coronary reperfusion.\;