急性心肌梗死患者溶栓治疗前后血清sICAM-1、sVCAM-1、IL-6及IL-8的动态观察

目的探讨急性心肌梗死 (AMI)溶栓治疗前后血清可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、白细胞介素 6 (IL 6 )、白细胞介素 8(IL 8)的动态变化。方法采用ELISA法观察 2 6例经尿激酶溶栓治疗及 2 2例常规治疗的AMI患者治疗前及治疗后 1、2、5、7、14天血清sICAM 1、sVCAM 1、IL 6、IL 8的动态变化并进行比较分析。结果治疗前两组间sICAM 1、sVCAM 1、IL 6、IL 8无差异 ,治疗后各指标变化趋势相似 ,但溶栓组sVCAM 1在治疗后第 5、7、14天显著高于对照组 (P <0 .0 1) ;而sICAM 1在第 5、7天明显低于对照组 (P <0 .0 1) ,IL 6在治疗后第 1、2、7天显著低于对照组 (P <0 .0 1) ,IL 8在治疗后第 1、7天明显低于对照组 (P <0 .0 1)。结论sICAM 1、sVCAM 1、IL 6、IL 8均可作为溶栓监测指标 ,其动态改变及作用影响AMI的发生、发展变化。溶栓治疗可减轻AMI的病理损伤 ,缩短病程。

The dynamic detections and significance of serum sICAM-1, sVCAM-1, IL-6 and IL-8 before and after thrombolysis in patients with acute myocardial infarction

Objective To investigate the dynamic changes of serum soluble intercellular adhesion molecule-1(sICAM-1), soluble vascular cell adhesion molecule-1(sVCAM-1), interleukin-1(IL-6) and interleukin-8(IL-8) in the patients with acute myocardial infarction(AMI). Methods The levels of serum sICAM-1, sVCAM-1, IL-6 and IL-8 before treatment and on 1,2,5,7,14 days after treatment were determined by means of ELISA in 26 patients with AMI treated by thrombolytic therapy with urokinase and 22 cases with conventional therapy. Results Before treatment, there were no significant differences in the contents of serum sICAM-1, sVCAM-1, IL-6 and IL-8. After treatment, the level of sICMA-1 was higher significantly in 5,7 and 14d than that of the control group(P<0.01). sVCAM-1 was lower markedly on 5 and 7 d than that of control group(P<0.01). IL-6 was lower on 1, 2 and 7 d than that of control group(P<0.01). IL-8 was lower significantly on 1 and 7d than that of control group(P<0.01). Conclusion sICAM-1, sVCAM-1, IL-6 and IL-8 may serve as thrombolytic monitoring index which dynamic changes and effect may influence the onset and development of AMI. Thrombolytic therapy with urokinase might reduce the pathological injury and shorten the course of disease.