血浆IL-8浓度在急性心肌梗死溶栓治疗后的变化及意义

Changes of Interleukin-8 and its Significance in Acute Myocardial Infarction after Thrombolytic Therapy

目的:了解急性心肌梗死(AMI)患者静脉溶栓治疗后血浆白细胞介素-8(IL-8)的动态变化并评价其临床意义。方法:对48例发病6小时内的AMI患者进行溶栓治疗,用放免法测定患者溶栓后0.5、1、2、4、12、48小时及1周血浆IL-8的变化。结果:48例患者中36例再通,12例未通。两组溶栓后血浆IL-8水平在溶栓后0.5、1、2、4、12、48小时均有统计学差异,均于48小时达峰值。结论:①IL-8参与急性心肌梗死发病和心肌缺血-再灌注的过程,血浆IL-8浓度能反映心肌梗死区域的炎症与损伤程度。②急性心肌梗死溶栓再灌注后血浆IL-8浓度较未灌注者低,溶栓再灌注挽救心肌而减轻的炎症反应程度足以抵消再灌注炎症损伤。③急性心肌梗死患者血浆IL-8动态变化及峰值浓度不是判断溶栓再通情况的较好指标。

Objective: To study the effects of reperfusion in acute myocardial infarction(AMI) patients on plasma's dynamic changes of interleukin-8 (IL-8) and its significance in patients who received thrombolytic therapy. Methods: In 48 patients with AMI who received thrombolysis within 6 hours after occurrence, the plasma level of IL-8 were measured by radioimmunological assay(RIA) at 30min, 1, 2, 4, 12, 48 hours and 1 week after thrombolysis. Results: 36 cases developed reperfusion(group A) and 12(group B) did not. There were significant differences of plasma levels of IL-8 between two groups at 30min, 1, 2, 4, 12, 48 hour after thrombolysis. The IL-8 level reached a peak blood concentration at 48 hours in both. Conclusions: IL-8 played a role in inflammatory response of AMI. It was not a good guide to use the dynamic curve and peak blood concentration of IL-8 reflecting the reperfusion in AMI. The reperfusion after thrombolytic therapy can reduce this kind of inflammatory response and can make benefits from offsetting inflammatory injury caused by reperfusion itself.