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目的:探讨缺血后处理对急性ST段抬高心肌梗死(STEMI)患者细胞因子的影响。方法:急性STEMI患者39例,随机分入对照组(17例)和缺血后处理组(22例)。各例接受急诊冠状动脉介入治疗术(PCI),对照组梗死血管再通后3min内不施加干预;缺血后处理组梗死血管再通后1min内应用低气压充盈和回缩球囊,每一过程各30s,反复3次。PCI术前和术后4h采血测定丙二醛(MDA)、超氧化物歧化酶(SOD),PCI术前和PCI术后12h采血测定肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)。结果:PCI术前2组患者MDA、SOD、TNF-α、IL-6差异无统计学意义,PCI术后缺血后处理组较对照组MDA、TNF-α、IL-6低[分别为(5.53±1.20)∶(6.70±1.24)μmol/L,(33.86±10.08)∶(41.09±11.36)ng/L,(72.07±11.09)∶(79.96±9.25)ng/L,P<0.05]而SOD高[(83.92±13.67)∶(74.31±14.68)U/L,P<0.05]。结论:缺血后处理可以减少急性STEMI患者血清中MDA、TNF-α、IL-6的生成,升高SOD。
Objective: To investigate the effect of ischemic postconditioning on cytokines in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Thirty-nine patients with acute STEMI were randomly divided into control group (17 cases) and ischemic postconditioning group (22 cases). In each case, PCI was performed in all patients undergoing PCI. In the control group, no intervention was given within 3 minutes after recanalization of the infarct. In the ischemic postconditioning group, the balloon was inflated and deflated within 1 min after recanalization of the infarct. The process of 30s, repeated 3 times. Blood samples were taken before and 4h after operation to determine the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and the levels of tumor necrosis factor-α (TNF-α), interleukin- 6 (IL-6). Results: There were no significant differences in MDA, SOD, TNF-α and IL-6 between the two groups before PCI, but the levels of MDA, TNF-α and IL-6 in ischemic postconditioning group were lower than those in control group 5.53 ± 1.20), (6.70 ± 1.24) μmol / L, (33.86 ± 10.08) :( 41.09 ± 11.36) ng / L, (72.07 ± 11.09) :( 79.96 ± 9.25) ng / L, P < High [(83.92 ± 13.67): (74.31 ± 14.68) U / L, P <0.05]. Conclusion: Ischemic postconditioning can reduce the serum levels of MDA, TNF-α and IL-6 and increase the level of SOD in acute STEMI patients.