急性心肌梗死患者外周血IL-6和sICAM-1活性的检测及其意义

目的 检测白介素-6（IL-6）与可溶性细胞间黏附分子-1（sICAM-1）在急性心肌梗死（AMI）患者外周血中水平，探讨其与心梗后心肌损伤严重程度的关系。方法 用ELISA法和放免法分别检测45例AMI患者和30例正常对照者的外周血sICAM-1和IL-6水平，并对AMI组分别按心功能不同和是否伴有室性心律失常分组，进行统计学处理，同时对sICAM-1和IL-6与射血分数的相关性进行分析。结果 ①AMI组外周血IL-6、sICAM-1水平均显著高于对照组（P〈0．01，P=0．039）；②AMI心功能Ⅲ、Ⅳ级组sICAM-1水平显著高于心功Ⅰ、Ⅱ级组（P〈0．01），Ⅱ级组又较Ⅰ级组明显增高；sICAM-1水平同射血分数呈负相关；而IL-6无此变化；③AMI伴室性心律失常组sICAM-1水平较不伴有室性心律失常组有显著性差异（P〈0．01），IL-6在两组间未见显著性差异（P=0．29）：④IL-6与sICAM-1未见明显相关性。结论AMI患者血浆ICAM-1而非IL-6水平同心肌损伤的严重程度有关。

Significance of Soluble Intercellular Adhesion Molecule-1 and Interleukin--6 in Acute Myocardial Infarction

Objective To investigate the relationship between the severity of myocardial lesion and the level of soluble intercellular adhesion molecule-1(sICAM-1) and interleukin-6 (IL-6) in patients of AMI. Methods Plasme soluble ICAM-1 and serum IL-6 were measured in 45 AMI patient and 30 healthy subjects by using enzyme-linked immunosorbent assay(ELISA) method and radioimmunoassay. Divided AMI patients into groups by killips classification and ventricular cardiac arrhythmias individually, then analyze them with statistic methods. Meanwhile analyze the relationship between IL-6?sICAM-1 and ejection fraction. Results The concentrations of sICAM-1 and IL-6 were significant higher in AMI patients than those in control. (both P<0.01); There were also significant difference in plasma sICAM-1 among different classes of cardiac performance according to Killip classification in AMI ( all P<0.01), and the plasma sICAM-1 was also higher in AMI patient accompanied by ventricular cardiac arrthythmias than those not accompanied by ventricular cardiac arrthythmias. (P<0.01); Ejection fraction was negatively related to sICAM-1(P<0.05), while there was no direct relationship between sICAM-1 and IL-6. Conclusions The level of plasma sICAM-1 is closely related to the severity of myocardial injury, but IL-6 did not contribute to the process of myocardial lesion in AMI.