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心肌梗死后患者冠状动脉中环氧化酶 2 的昼夜节律变化。

Circadian variations of interleukin 6 in coronary circulations of patients with myocardial infarction.

机构信息

Medical University of Bialystok, Department of Cardiology, ul. Sklodowskiej 24a, Bialystok, Poland.

出版信息

Cytokine. 2010 May;50(2):204-9. doi: 10.1016/j.cyto.2010.01.007. Epub 2010 Feb 18.

Abstract

UNLABELLED

We hypothesize that higher morbidity of patients with ST-segment elevation myocardial infarction (STEMI) in the out-of-office hours differences in outcome after myocardial infarction may depend on the concentrations of inflammatory cytokines. The aim of the study was to determine the relation between the time of percutaneous coronary intervention (PCI) and local concentration of interleukin 6 (IL-6) and its soluble receptors (sIL-6R and sgp130) in patients with STEMI.

METHODS AND RESULTS

The study included 32 patients with invasively treated left anterior descending artery occlusion and no significant co-morbidities. Blood samples were drawn from coronary sinus and aorta before and after intervention. Patients admitted in the afternoon (13-20) presented significantly higher mean IL-6 levels in all samples than patients admitted in the morning. There was a positive correlation between time of intervention and concentrations of IL-6 in all samplings, but also with transcardiac IL-6 gradient at the end of procedure and IL-6 increase during PCI. We did not find any significant association between time of PCI and concentrations of sIL-6R and sgp130, time from pain to balloon, angiographic parameters or medical history.

CONCLUSIONS

Coronary concentration of IL-6 in patients with STEMI is significantly higher in the afternoon than in the morning. This might be involved in increased morbidity of those patients.

摘要

未注明

我们假设,在非工作时间就诊的 ST 段抬高型心肌梗死(STEMI)患者的发病率较高,而心肌梗死后的结果可能取决于炎症细胞因子的浓度。本研究旨在确定经皮冠状动脉介入治疗(PCI)时间与 STEMI 患者局部白细胞介素 6(IL-6)及其可溶性受体(sIL-6R 和 sgp130)浓度之间的关系。

方法和结果

本研究纳入了 32 例接受经皮冠状动脉介入治疗的左前降支闭塞且无明显合并症的患者。在介入治疗前后分别从冠状动脉窦和主动脉抽取血样。下午(13-20 点)就诊的患者在所有样本中的平均 IL-6 水平均显著高于上午就诊的患者。干预时间与所有采样的 IL-6 浓度呈正相关,但与手术结束时跨心的 IL-6 梯度和 PCI 期间的 IL-6 增加也呈正相关。我们没有发现 PCI 时间与 sIL-6R 和 sgp130 的浓度、从胸痛到球囊的时间、血管造影参数或病史之间存在任何显著关联。

结论

STEMI 患者的冠状动脉内 IL-6 浓度下午明显高于上午,这可能与这些患者发病率较高有关。

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