白介素-8在急性心肌梗死后ST段再抬高时的作用

Effects of interleukin-8 on ST-segment re-elevation after acute myocardial infarction

目的 探讨急性心肌梗死 (AMI)溶栓后血清白介素 - 8(IL - 8)的动态变化及在ST段再抬高时的作用。方法 将静脉溶栓治疗的AMI患者 34例按临床判定指标分为冠脉再通组 (2 2例 )和冠脉未通组 (12例 ) ,所有AMI患者除常规心电图和心电监护外 ,在溶栓前和溶栓后 2、 4、 6、 8、 10、 12、 16、 2 0和 2 4小时抽血检测血清IL - 8,并检测肌酸磷酸激酶 (CK)。结果 冠脉再通的 2 2例中有 5例在 2 4小时内ST段出现再抬高 ,ST段再抬高者 (5例 )IL - 8峰值出现在发病后 10小时 ,无ST段再抬高者 (17例 )IL - 8峰值为 12小时 ;ST段再抬高组血清IL - 8在溶栓后 4小时低于无ST段再抬高组 (16 3± 10和 179± 12pg/ml,P <0 0 5 ) ,而在 10小时时前者又明显高于后者 (2 2 6± 11和 189± 10 pg/ml,P <0 0 5 )。 结论 AMI溶栓冠脉再通后 ,早期ST段再抬高可能与缺血 /再灌注使IL - 8释放。

Objective To study the change of interleukin-8 (IL-8) in the patients with acute myocardial infarction (AMI) during thrombolysis,and diagnostical value on ST-segment re-elevation.Methods Thirty-four patients with AMI were venously received urokinase (UK) thrombolysis,and divided into coronary reperfusion group (n=22) or coronary no reperfusion group (n=12).Serum IL-8 by Elisa enzyme techniques were measured at admission and 2,4,6,8,10,12,16,20,24 hours after thrombolysis.Results IL-8 level was significantly lower at 4 hour after thrombolysis in ST-segment re-elevation group (n=5) than that in ST-segment no re-elevation group (n=17), 163±10vs179±12pg/ml, P<0.05, but significantly higher at 10 hour after thrombolysis in the anter than the latter,226±11vs189±10pg/ml,P<0.05 IL-8 peak in ST-segment re-elevation group imerges later than in ST-segment no re-elevation group.Conclusion IL-8 plays a critical role in the early ST-segment re-elevation in myocardial schema postreperfusion inflammatory injury.It is possible that IL-8 is released in ischemia and/or reperfusion,and activates neutrophils with mediated vessel endothelial injury,and induces microvessel block.