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目的 探讨急性心肌梗死 (AMI)溶栓后血清白介素 - 8(IL - 8)的动态变化及在ST段再抬高时的作用。方法 将静脉溶栓治疗的AMI患者 34例按临床判定指标分为冠脉再通组 (2 2例 )和冠脉未通组 (12例 ) ,所有AMI患者除常规心电图和心电监护外 ,在溶栓前和溶栓后 2、 4、 6、 8、 10、 12、 16、 2 0和 2 4小时抽血检测血清IL - 8,并检测肌酸磷酸激酶 (CK)。结果 冠脉再通的 2 2例中有 5例在 2 4小时内ST段出现再抬高 ,ST段再抬高者 (5例 )IL - 8峰值出现在发病后 10小时 ,无ST段再抬高者 (17例 )IL - 8峰值为 12小时 ;ST段再抬高组血清IL - 8在溶栓后 4小时低于无ST段再抬高组 (16 3± 10和 179± 12pg/ml,P <0 0 5 ) ,而在 10小时时前者又明显高于后者 (2 2 6± 11和 189± 10 pg/ml,P <0 0 5 )。 结论 AMI溶栓冠脉再通后 ,早期ST段再抬高可能与缺血 /再灌注使IL - 8释放、激活中性粒细胞和血管内皮损害有关
Objective To investigate the dynamic changes of serum interleukin - 8 (IL - 8) after acute myocardial infarction (AMI) thrombolysis and its role in reenergization of ST segment. Methods Thirty-four patients with AMI treated by intravenous thrombolysis were divided into coronary recanalization group (n = 22) and coronary recanalization group (n = 12) according to the clinical criteria. All AMI patients except for routine ECG and ECG, Serum IL - 8 levels were measured before blood clotting and at 2, 4, 6, 8, 10, 12, 16, 20 and 24 hours after thrombolysis, and creatine phosphokinase (CK) was measured. Results Among the 22 cases of recanalization, 5 cases recurred in ST segment within 24 hours. The peak of IL - 8 in ST segment elevation (5 cases) appeared at 10 hours after onset of ST segment The elevation of IL - 8 was observed in 17 patients with elevation of serum IL - 8 level. The serum levels of IL - 8 in ST elevation group were lower at 4h after thrombolysis than in those without ST segment elevation (16 3 ± 10 and 179 ± 12pg / ml, P <0 05), while the former was significantly higher than the latter at 10 hours (2 26 ± 11 and 189 ± 10 pg / ml, P 0 05). Conclusions After AMI thrombolysis and coronary recanalization, the early re - elevation of ST segment may be related to the release of IL - 8 and the activation of neutrophil and vascular endothelial cell damage induced by ischemia / reperfusion