陈仲敏,黄达梅,吴立荣
CHEN Zhong min, HUANG Da mei, WU Li rong (Department of Cardiovascular Internal Medicine,the Affiliated Hospital of GuiYang Medical College, GuiYang 550004 ,China)

• 1:贵阳医学院附院内科
• 2:贵阳医学院附院内科
• 3:贵阳医学院附院内科 贵州贵阳550004
• 4:贵州贵阳550004

摘要(Abstract)：

目的 :探讨血清sICAM - 1、IL - 6、CRP水平与急性心肌梗死 (AMI)的关系 ,为AMI的预防和炎症干预治疗提供理论依据。方法 :用酶联免疫吸附法 (ELISA)及放免法测定 2 7例AMI病人入院及住院 4周时的血清sICAM - 1、CRP、IL - 6水平 ,并观察病人预后。同时设立对照组 2 1例。结果 :AMI组入院时sICAM - 1、IL - 6、CRP水平显著升高 ,与对照组比较差异有显著性 (P <0 .0 5 ) ;住院 4周时sICAM - 1、IL - 6、CRP水平仍显著升高 ,与对照组比较差异仍有显著性 (P <0 .0 5 ) ,但与入院时比较差异无显著性 (P >0 .0 5 )。AMI组 3例尿激酶静脉溶栓治疗有效的病人住院 4周时sICAM - 1、IL - 6、CRP水平较入院时有明显下降 ,平均分别下降 2 5 .7%、2 5 .7%、4 2 9%。AMI组中 8例再发ACS患者入院及住院 4周时sICAM - 1、IL - 6、CRP水平均高于治疗方法相同、未再发ACS的另 16例患者 ,但两者间相比仅sICAM - 1的差异有显著性 (P <0 .0 5 )。结论 :AMI患者血清sICAM - 1、IL - 6、CRP水平显著升高 ,间接提示炎症可能参与了AMI的发病过程 ,而sICAM - 1、IL - 6在其中可能起了重要作用 ;测定sICAM - 1可能对判断AMI患者的预后有一定价值。
Objective: To explore the relationship between sICAM-1, IL-6 or CRP and acute myocardcal infarction (AMI). Methods: Serum sICAM-1, IL-6 and CRP levels were measured in 27 patients and in control group. Blood samples of the patients were taken on admission and in 4 weeks after admission respectively. Levels of sICAM-1 and CRP were measured with enzyme-linked immunosorbent assay (ELISA), while levels of IL-6 were measured by radioimmnoassay. Results: Serum sICAM-1, IL-6 and CRP were significantly higher in the patients on admission than those in control group (P<0.05) . In 4 weeks after admission, serum sICAM-1, IL-6 and CRP were still higher than that of control group.And there was no significant difference between the levels on admission and those in 4 weeks after admission in the patients (P>0.05). Serum sICAM-1, IL-6 and CRP levels of 3 patients with AMI receiving thrombolytic therapy decreased significantly at 4 weeks after admission by 25.7%, 25.7%, 42.9% respectively. The sICAM-1, IL-6 and CRP levels of 8 patients had relapse of ACS were higher than those of the other 16 patients who hadn' t the relapse of ACS but with the same treatment. Significant difference in sICAM-1 levels was found between the two groups both on admission and in 4 weeks after admission. Conclusions: Serum levels of sICAM-1, IL-6 and CRP in the patients with AMI increased significantly , which indicated indirectly that inflammation may involve in the pathogenesis of AMI, and that sICAM-1, IL-6 may play important roles in the pathogenesis of AMI. Measurement of serum sICAM-1 levels may be helpful in prediction of the prognosis of the patients with AMI.

关键词(KeyWords)： 心肌梗塞;酶联免疫吸附测定;细胞粘着分子;白细胞介素6;C反应蛋白质
myocardial infarction;enzyme linked immunosorbent assay; all adhesion molecules;interleukin-6;c-reactive protein

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈仲敏,黄达梅,吴立荣
CHEN Zhong min, HUANG Da mei, WU Li rong (Department of Cardiovascular Internal Medicine,the Affiliated Hospital of GuiYang Medical College, GuiYang 550004 ,China)

Email:

DOI: 10.19367/j.cnki.1000-2707.2002.04.007

参考文献(References)：

• [1]MehtaJL ,SaldeenTG ,RandK .Interactiveroleofinfec tion,inflammationandtraditionalriskfactorsinatherosclerosisandcoronaryarterydisease[J].JAmCollCardiol,1998,31(6):1217-1225.
• [2]ShyuKG ,ChangH ,LinCC ,etal.Circulatingintercellu laradhesionmolecule-1andE -selectininpatientswithacutecoronarysyndrome[J].Chest,1996,109(6):1627-1630.
• [3]关瑜,张梦玺,袁洪,等内皮素及细胞因子在冠心病发病中的意义[J]湖南医科大学学报,1998,23(6):569-571.
• [4]ShyuKG .Circulatingintercellularadhesionmolecule-1andE -selectininpatientswithacutecoronarysyndrome[J].Chest,1996,109:1627-1230.
• [5]王欣,杨学萍,李玉光,等冠心病患者C反应蛋白水平的观察[J]中国循环杂志,2000,15(4):236.
• [6]CouffinhalT ,DuplaaC ,MoreauC ,etal.Regulationofvascularcelladhesionmolecule-1andintercellularadhe sionmolecule-1inhumanvascularsmoothmusclecells[J].CireRes,1994,74:225-234.
• [7]MehtaJ ,DinermanJ ,MehtaP ,etal.Nertrophilfunc tioninischemicheartdisease[J].Circulation,1989,79(3):549-556.
• [8]DustinMJ.InductionbyIL -1andinterferon-γ:tissuedistribution,biochemistryandfunctionofanaturaladher encemolecule(ICAM -1)[J].JImmunol,1986,137:245.
• [9]RusH ,NiculescuFI .Inflammation,aspirin,andtheriskofcardiovasculardisease[J].NEnglJMed,1997,337:422-424.
• [10]SquaditoF ,SaittaA ,AltavillaD ,etal.Thrombolytictherapywithurokinasereducesincreasedcirculatingen dothelialadhesionmoleculesinacutemyocardialinfarction[J].Inflamm　Res,1996,45(1):14-19.
• [11]Puil-R ,PidrmanV ,KrejsekJ ,etal.TheeffectofreperfusiononplasmatumornecrosisfactoralphaandC-reactiveproteinlevelsinthecourseofacutemyocardialinfarction[J].Acta　Medica　Hradec　Kralove,1996,39(4):149-153.

文章评论(Comment)：