血糖对急性心肌梗死患者急诊介入治疗前后血清IL-6及PDGF水平的影响

目的:研究血糖水平与急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入治疗（PCI）术前后血清白细胞介素6（IL-6）、血小板源性生长因子（PDGF）水平的关系,及其对患者近期预后的影响，探讨其可能机制。方法:将54例AMI发病10 h内接受急诊PCI治疗成功患者分为3组（1组：无糖尿病病史，入院随机血糖<8.0 mmol·L^-1；2组：无糖尿病病史，入院随机血糖≥8.0 mmol·L^-1；3组：糖尿病患者）。应用酶联免疫吸附测定法检测PCI术前10 min、术后24及48 h静脉血清中IL-6及PDGF水平。 结果：各组患者术中严重心律失常及住院期间心功能不全发生率比较差异无显著性（P>0.05），但2及3组高于1组。各组患者随血糖增高，各时间点IL-6、PDGF水平均逐渐增高，3组>2组>1组（P<0.05）。1组术后48 h IL-6水平基本达术前水平，而2组及3组回落较慢。1组术后24及48 h PDGF水平较术前略增高，2组PDGF水平低于3组，但明显高于1组（P<0.05）。结论: 应激性高血糖可能增加AMI行PCI患者炎症反应水平，并延长炎症反应持续时间，增加术中严重心律失常、住院期间心功能不全的发生率。

Influence of blood glucose concentration on levels of IL-6 and PDGF in patients with acute myocardial infarction treated by primary percutaneous coronary intervention

Objective To study the effects of blood glucose concentration on the levels of IL-6and platelet derived growth factor (PDGF)before and after operation and short-term prognosis in patients with acute myocardial infarction (AMI)treated by primary percutaneous coronary intervention (PCI),and discuss the possible mechanisms of those effects.Methods A total of 54patients with AMI treated with successful primary PCI within 10hafter onset of symptoms were divided into three groups:groupⅠ,non-diabetic patients with blood glucose level<8.0mmol·L-1;groupⅡ,non-diabetic patients with blood glucose level≥8.0mmol·L-1;groupⅢ, diabetic patients.The method of enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of blood serum IL-6and PDGF before PCI 10min and 24and 48hafter PCI.Results There were no differences in the incidence rates of serious arrhythmia in operation and heart failure duration of hospital between three groups (P<0.05),but the incidence rates in groupⅢand groupⅡ were higher than that in groupⅠ.The levels of IL-6 and PDGF were increased with blood glucose level in three groups,groupⅢ >groupⅡ> group I,there were significant differences(P<0.05).The level of IL-6 48hafter PCI in groupⅠ wasdecreasedtothelevelbeforePCI,the descent in groupⅡandⅢ was slow.The PDGF levels 24and 48hafter PCI had been little higher than before PCI in group I,the level of PDGF in groupⅡ was lower than that in groupⅢ and higher than that in groupⅠ (P<0.05).Conclusion Stress hyperglycemia in patients with AMI treated by primary PCI maybe increase the levels of inflammatory reaction,extend the time of inflammatory reaction,increase the incidence rates of serious cardiac arrhythmia in operation and heart failure duration of hospital stay.