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目的:探讨急性心肌梗死(AMI)心肌缺血再灌注过程中血浆白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)的动态变化及其意义。方法:采用单抗夹心ELISA方法,观察比较27例经链激酶(SK)或重组组织型纤溶酶原激活剂(rt-PA),溶栓治疗的AMI患者溶栓前,溶栓后2h、4h、8h、10h、12h血浆IL-8和TNF-α动态变化,并进行统计学分析。结果:27例观察组AMI患者中,14例溶栓治疗后相关血管再通者(再通组),13例溶栓治疗相关血管未通者(未通组),再通组IL-8、TNF-α各时间点与正常对照组间有显著差异(F=51.474、F=21.322,均P<0.01),未通组IL-8、TNF-α各时间点与正常对照组间有显著差异(F=43.694、F=36.45,均P<0.01)。再通组与未通组IL-8比较2h、4h(t=7.652、t=3.054,均P<0.01)有显著性差异,再通组与未通组TNF-α比较2h,4h(t=1.667、t=19.389),(P<0.05和P<0.01)也有显著性差异。两组溶栓治疗前IL-8、TNF-α比较(q=2.498、q=0.326,均P>0.05)无显著性差异。结论:IL-8、TNF-α在心肌缺血再灌注后炎症损伤中起关键作用,监测IL-8,TNF-α动态变化有助于临床对AMI再灌注损伤的认识,对防治AMI再灌注后炎症损伤的认识,对防治AMI再灌注后炎症损伤有一定实用价值。
Objective: To investigate the dynamic changes of plasma interleukin 8 (IL-8) and tumor necrosis factor-α (TNF-α) during myocardial ischemia-reperfusion in acute myocardial infarction (AMI) and its significance. Methods: MALDI-TOF-MS was used to observe and compare the clinical efficacy of 27 patients with AMI treated by streptokinase (SK) or recombinant tissue plasminogen activator (rt-PA) before thrombolysis, 2h after thrombolysis, 4h, 8h, 10h, 12h plasma IL-8 and TNF-α dynamic changes, and statistical analysis. Results: Of 27 AMI patients in the observation group, 14 were related to recanalization (recanalization) after thrombolysis, 13 were not related to thrombolytic therapy, There was a significant difference between the control group and the TNF-α at each time point (F = 51.474, F = 21.322, all P <0.01). The levels of IL-8 and TNF- (F = 43.694, F = 36.45, all P <0.01). There was a significant difference between the recanalization group and the untreated group in 2h, 4h (t = 7.652, t = 3.054, all P <0.01) 1.667, t = 19.389), (P <0.05 and P <0.01) also had significant differences. There was no significant difference in the levels of IL-8 and TNF-α between the two groups before thrombolysis (q = 2.498, q = 0.326, all P> 0.05). CONCLUSION: IL-8 and TNF-α play a key role in the inflammatory injury after myocardial ischemia and reperfusion. Monitoring the dynamic changes of IL-8 and TNF-α is helpful to the clinical understanding of AMI reperfusion injury. Post-inflammatory injury awareness, prevention and treatment of AMI after reperfusion inflammatory injury has some practical value.