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目的探讨可溶性细胞间黏附分子-1(ICAM-1)和肿瘤坏死因子-α(TNF-α)在老年急性心肌梗死患者血清中的变化及其意义。方法研究对象为老年急性心肌梗死患者48例、稳定型心绞痛患者及体检正常者各30例,分别测定其血清ICAM-1及TNF-α浓度,比较AMI患者不同时间点及不同组间血清含量变化。结果老年心肌梗死组发病第1天血清ICAM-1、TNF-α均明显高于健康对照组,与稳稳定型心绞痛组发病第1天比较差异具有统计学意义(均为P<0.01)。老年心肌梗死组发病后第1天血清ICAM-1、TNF-α均明显增高,第7天降低,第14天基本恢复正常,3个不同发病时间点之间比较差异有统计学意义(P<0.05)。老年急性心肌梗死患者血清TNF-α与ICAM-1呈正相关(r=0.613,P<0.001)。结论监测老年急性心肌梗死患者血清ICAM-1与TNF-α水平,对本病的诊断、判定病程的进展及临床疗效均具有一定的作用。
Objective To investigate the changes and significance of serum soluble intercellular adhesion molecule-1 (ICAM-1) and tumor necrosis factor-α (TNF-α) in elderly patients with acute myocardial infarction. Methods: Forty-eight elderly patients with acute myocardial infarction, 30 patients with stable angina and 30 normal subjects were enrolled in this study. Serum concentrations of ICAM-1 and TNF-α were measured respectively. Serum levels of AMI patients at different time points and in different groups were compared . Results The serum levels of ICAM-1 and TNF-α in the elderly myocardial infarction group were significantly higher than those in the healthy control group on the first day after onset of onset. The difference was statistically significant (all P <0.01) on the first day after onset of stable angina pectoris group. Serum ICAM-1 and TNF-α were significantly increased on the first day after onset in the elderly myocardial infarction group, decreased on the 7th day and returned to normal on the 14th day, with significant difference between the 3 different time points (P < 0.05). Serum TNF-α and ICAM-1 in elderly patients with acute myocardial infarction were positively correlated (r = 0.613, P <0.001). Conclusions Monitoring serum levels of ICAM-1 and TNF-α in elderly patients with acute myocardial infarction may play a role in the diagnosis of the disease, the progress of the course of the disease and the clinical efficacy.