冠脉成形术缺血性刺激前后血清IL-6、TNF-α水平的变化

目的:冠脉成形术(PTCA)引起的炎症反应始于术后早期。白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)是主要的炎性细胞因子。本实验拟通过对比有或没有侧支循环病人PTCA前后IL-6、TNF-α水平的变化,探讨PTCA引起早期炎性反应的机制。方法:参照Leaman冠脉积分系统,对PTCA球囊阻断引起的缺血强度进行量化。计算正常对照组与冠心病组PTCA手术前后的IL-6、TNF-α水平变化,并进行相关性分析。结果:缺血性剌激前IL-6和TNF-α分别为(9.592±1.847)ng/L和(26.959±1.967)ng/L。在剌激后4h分别为(27.423±1.882)ng/L和(78.542±1.573)ng/L,呈显著差异。结论:IL-6、TNF-α是反映PTCA术后早期炎性反应的敏感指标。缺血积分可作为反映PTCA术中缺血/再灌注损伤程度的量化指标。侧支循环可减轻PTCA术后早期炎症反应。

Alteration of serum interleukin-6 and tumor necrosis factor-α after ischemic stimulation of coronary artery in PTCA

AIM: Inflammatory responses play an important role in the post- percutaneous transluminal coronary angioplasty (PTCA) restenosis and has been demonstrated occuring immediately after PTCA. Interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) are the main inflammatory cytokines. We try to compare the changes in interleukin-6(IL-6) and TNF-α after PTCA in the patients with and without collateral circulation to probe into the pathogenesis of early inflammatory response. METHODS: The extent of myocardial ischemia induced by balloon inflation was quantified by a scoring system referring to the Leaman coronary score. The IL-6、TNF-α levels of coronary heart disease group and control group before and after PTCA are calculated. RESULTS: The concentrations of IL-6 and TNF-α were (9.592±1.847) ng/L and (26.959±1.967) ng/L, respectively, and were significantly increased 4 hours after PTCA. CONCLUSION: IL-6 and TNF-α are sensitive indicators of the early inflammatory response after PTCA. Ischemia scores reflected the extent of ischemia reperfusion injury during PTCA. Collateral circulation decreased the early inflammatory response after PTCA.