白细胞介素-6和肿瘤坏死因子α与心肌梗死面积及胶原形成的关系
Interleukin-6 and tumor necrosis factor alpha in relation to myocardial infarct size and collagen formation.
作者信息
Puhakka Mikko, Magga Jarkko, Hietakorpi Seppo, Penttilä Ilkka, Uusimaa Paavo, Risteli Juha, Peuhkurinen Keijo
机构信息
Department of Internal Medicine, Kuopio University Hospital, Kuopio, Finland.
出版信息
J Card Fail. 2003 Aug;9(4):325-32. doi: 10.1054/jcaf.2003.38.
BACKGROUND
Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) levels increase after acute myocardial infarction (AMI) in humans. Experimental data suggest that these cytokines regulate the initiation of scar formation after AMI. We investigated the interrelationships of IL-6 and TNF-alpha, tissue injury, infarct size, cardiac function, and collagen formation in humans.
METHODS
Serum and plasma samples were taken on 93 patients receiving thrombolytic treatment for their first AMI. Collagen formation was evaluated by measuring concentrations of serum aminoterminal propeptide of type III procollagen (PIIINP).
RESULTS
IL-6 levels increased by 44% (P<.001) and peaked at 24 hours. Peak IL-6 levels correlated positively with area under the curve of creatine kinase MB mass (r=.31, P<.01), peak troponin T level (r=.34, P<.005), and PIIINP measured at discharge (r=.46, P<.001). There were no changes in TNF-alpha levels, and patients with left ventricular dysfunction (EF<40%) had similar TNF-alpha levels as those with preserved left ventricular function.
CONCLUSIONS
IL-6 may regulate collagen formation and thus remodeling of the left ventricle after AMI. In addition, TNF-alpha measurement is useless in the assessment of infarct size or left ventricular function during the immediate post-infarction period.
背景
人类急性心肌梗死（AMI）后白细胞介素-6（IL-6）和肿瘤坏死因子α（TNF-α）水平升高。实验数据表明，这些细胞因子调节AMI后瘢痕形成的起始过程。我们研究了人类IL-6与TNF-α、组织损伤、梗死面积、心功能及胶原形成之间的相互关系。
方法
对93例首次发生AMI并接受溶栓治疗的患者采集血清和血浆样本。通过检测血清Ⅲ型前胶原氨基端前肽（PIIINP）浓度评估胶原形成情况。
结果
IL-6水平升高44%（P<0.001），并在24小时达到峰值。IL-6峰值水平与肌酸激酶MB质量曲线下面积呈正相关（r=0.31，P<0.01），与肌钙蛋白T峰值水平呈正相关（r=0.34，P<0.005），与出院时测得的PIIINP呈正相关（r=0.46，P<0.001）。TNF-α水平无变化，左心室功能不全（EF<40%）患者的TNF-α水平与左心室功能正常患者相似。
结论
IL-6可能调节胶原形成，从而在AMI后调节左心室重构。此外，在梗死发生后的即刻，TNF-α检测对于评估梗死面积或左心室功能并无用处。
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