PTCA前后血清IL-6、TNF-α水平的变化

ELEVATION OF SERUM INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR-α AFTER ISCHEMIC STIMULATION OF CORONARY ARTERY IN PTCA

目的 :通过对比有无侧枝循环的冠心病患者冠脉成形术 (PTCA)前后白细胞介素 6 (IL 6 )、肿瘤坏死因子 (TNF α)水平的变化 ,探讨PTCA引起早期炎性反应的机制。方法 :参照Leaman冠脉积分系统 ,对PTCA球囊阻断引起的缺血强度进行量化。计算正常对照组与冠心病组PTCA手术前后的IL 6、TNF α水平变化 ,并进行相关性分析。结果 :缺血性刺激前IL 6和TNF α分别为 (9 5 92± 1.847) pg/ml和(2 6 95 9± 1.96 7) pg/ml,在缺血刺激后 4h分别为 (2 7 42 3± 1.882 ) pg/ml和 (78.5 4 2± 1.5 73) pg/ml,呈显著性差异。结论 :IL 6、TNF α是反映PTCA术后早期炎性反应的敏感指标 ,缺血积分可作为反映PTCA术中缺血 /再灌注损伤程度的量化指标 ,侧支循环可减轻PTCA术后早期炎症反应。

Objective:Inflamatory responses play an important role in the post percutaneous transluminal coronary angioplasty(PTCA) restenosis and have been demonstrated occuring immediately after PTCA.Interleukin 6(IL 6) and the tumor necrosis factor α(TNF α) are the main inflamatory cytokines.We try to compare the changes of Interleukin 6(IL 6) and the tumor necrosis factor α(TNF α) after PTCA in the patients with and without collateral circulation to probe into the pathogenesis of early inflammatory response.Methods:The extent of myocardial ischemia induced by balloon inflation was quantified by a scoring system referring to the Leaman coronary score.The IL 6,TNF α levels of coronary heart disease group and control group before and after PTCA are calculated.Results:The concentrations of IL 6 and TNF α were (9.592±1.847)pg/ml and (26.959± 1.967 )pg/ml;and were significantly increased(27.423±1.882)pg/ml and(78.542±1.573)pg/ml 4 hours after PTCA.Conclusion:IL 6 and TNF α are sensitive resembles of the early inflamatory response after PTCA.Ischemia scores reflected the extent of ischemia refusion injury during PTCA.Collateral circulation decreased the early inflamatory response after PTCA.