急性心肌梗死介入治疗后临床预后与白细胞介素-6的关系

目的观察急性心肌梗死(AMI)介入治疗后,白细胞介素6(IL-6)水平、白细胞计数和单核细胞比及高敏C反应蛋白(hs-CRP)与心脏收缩功能及心脏事件的关系。方法32例首次前壁AMI行急诊介入治疗患者,记录患者AMI介入治疗后24 h白细胞计数、单核细胞比及hs-CRP水平,AMI后第3天测定患者血浆IL-6水平,随访6个月。25例无冠心病病史,且超声心动图检查正常者为对照组。结果AMI组IL-6水平高于对照组(P<0.05);IL-6水平与心功能Killip分级呈正相关(r=0.64,P<0.01);与AMI后3个月及6个月时左室射血分数呈负相关,r值分别为-0.59及-0.47(均P<0.01);Killip分级≥2级、严重心律失常、心包积液患者的IL-6水平明显高于无心脏事件的患者,P<0.05;Killip分级≥2级的患者hs-CRP水平明显高于Killip分级1级的患者。结论IL-6是AMI左室收缩功能严重受损以及发生心脏事件的预测因子。

Relationship between serum level of interleukin-6 and clinic prognosis in patients with acute myocardial infarction after percutaneous coronary intervention therapy

Objective To observe the relationship between interleukin-6(IL-6),leukocytes count,percent monocytes,high-sensitivity C-reactive protein and left ventricular function and cardiac events in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).Methods Serum level of interleukin-6 was measured on the 3rd day and leukocytes count,percent monocytes and high-sensitivity C-reactive protein(hs-CRP) 24 hours after AMI in 32 patients with AMI after PCI,who were then followed 6 months.25 healthy persons without coronary heart disease were recurited as control.Results The level of IL-6 in patients with AMI was higher than that in control group(P<0.05).The level of IL-6 in AMI patients was correlated positively with degree of Killip(r=0.64,P<0.01),and negatively with left ventricular ejection fraction at 3 months and 6 months after AMI(all P<0.01).The level of IL-6 was higher in patients with Killip class≥2,severe arrhythmia and pericardial effusion than that in patients without cardiac events(P<0.05).The level of hs-CRP was higher in patients with Killip class≥2 than that in patients with Killip class 1.Conclusion The level of IL-6 in patients with AMI is the prognostic factor for left ventricular systolic function impairment and cardiac events.