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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 investigate the dynamic change of plasma interleukin-8 (IL-8) after intravenous thrombolysis in patients with acute myocardial infarction (AMI) and evaluate its clinical significance. Methods: Thirty-eight patients with AMI within 6 hours after onset of thrombolysis were enrolled in this study. Plasma IL-8 levels at 0.5, 1, 2, 4, 12, 48 hours and 1 week after thrombolysis were measured by radioimmunoassay. Results: Of the 48 patients, 36 recanalized and 12 failed. Plasma IL-8 levels after thrombolysis in both groups were statistically different at 0.5, 1, 2, 4, 12 and 48 hours after thrombolytic therapy, both reached their peak at 48 hours. IL-8 is involved in the pathogenesis of acute myocardial infarction and myocardial ischemia-reperfusion. The concentration of plasma IL-8 can reflect the degree of inflammation and injury in myocardial infarction area. (2) The concentration of plasma IL-8 in thrombolytic and reperfusion-induced acute myocardial infarction was lower than that in the non-perfusion group. The degree of inflammatory response relieved by thrombolytic and reperfusion rescued myocardium was enough to counteract the inflammatory injury after reperfusion. ③ The dynamic changes of IL-8 in plasma and the peak concentration in patients with acute myocardial infarction are not good indicators to judge the recanalization of thrombolysis.