糖尿病患者急性心肌梗死后炎性因子的变化及其意义

①目的 探讨糖尿病患者在心肌梗死后炎性因子的变化及其意义.②方法 87例急性心肌梗死患者分为血糖正常组（64例）及糖尿病组（23例）,另选健康对照组（25例）.采用酶联免疫吸附法（ELISA）测定各组患者入院即刻、第24小时、第48小时、第5天,第7天、第14天血清白介素-1β（IL-1β）、白介素-6（IL-6）,白介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）含量;健康对照组测1次上述各项指标.③结果 与对照组相比,心肌梗死患者的炎性因子浓度于发病2周内明显升高（P＜0.01）,存在动态变化;炎性因子含量除糖尿病组的血清IL-1第24小时～第14天、IL-6第5～14天及IL-8第5～7天数值较血糖正常组有明显升高外（P＜0.05）,其它数值两组无明显差异（P＞0.05）.④结论 炎症参与了急性心肌梗死全过程,在急性心肌梗死早期的炎性反应中糖尿病起到了一定的促进作用,且主要影响白介素系统,而对肿瘤坏死因子及干扰素无明显影响.

Change and significance of inflammatory factors in diabetic patients with acute myocardial infarction

Objective To investigate the change and significance of inflammatory factors in diabetic patients with acute myocardial infarction（AMI）. Methods According to bloSd glucose, 87 ST- elevation myocardial infarction （STEMI） patients were separated into normal group（ 64 cases） and diabetic group（23 cases）, and 25 cases were chosen as health control group. Plasma levels of Interleukin （IL） - 1β, IL - 6, IL - 8, TNF -αand IFN - Гat the point of pre - hospitalization, 24h, 48 h, 5d, 7 d and 14d were measured with ELISA method. Results Compared with the control group,the levels of inflammatory factors in the AMI patients raised significantly during 2 weeks and showed dynamic change. Compared with normal group, the contents of inflammatory factors of IL - 1 from 24th h to 14th d, IL - 6 from 5th d to 14th d and IL - 8 from 5th d to 7th d in diabetic group raised significantly（ P 〈 0.05）, but others had no difference（ P 〉 0.05）. Conclusions Inflammatory took part in the course of AMI. In the early stage of AM], diabetic accelerated inflammatory reaction and mainly affected the interleukin system, hut had no evidence effects on TNF and IFN.