Neumann F J, Ott I, Wilhelm A, Katus H, Tillmanns H, Schömig A
1. Medizinische Klinik, Technische Universität München, Germany.
Eur Heart J. 1994 Feb;15(2):171-8. doi: 10.1093/oxfordjournals.eurheartj.a060472.
The study investigated inflammatory responses in evolving myocardial infarction. Fifteen patients with acute myocardial infarction, who had undergone balloon recanalization of the infarct-related coronary artery within 4 h after onset of symptoms, were examined. Blood samples were obtained through the guiding catheter and from the pulmonary artery before and immediately after successful recanalization. After recanalization, plasma from the pulmonary artery was 47% (quartiles: 19%, 78%; P = 0.001) more chemotactic to neutrophils from normal donors than before recanalization. Furthermore, significant changes in neutrophil function were found in the pulmonary artery. Compared to the values before recanalization, the nitroblue tetrazolium score rose by 31% (quartiles: 4%, 37%; P = 0.003), FMLP-stimulated superoxide anion production by 10% (quartiles: 0%, 39%; P = 0.020), and chemotaxis by 46% (quartiles: 0%, 81%; P = 0.011), while neutrophil filterability decreased by 28% (quartiles: 15%, 47%; P = 0.010). No significant changes in neutrophil parameters were found in the arterial blood. The study indicates that chemoattractants are released in the early reperfusion period of evolving myocardial infarction. These chemoattractants may act as inflammatory mediators causing neutrophil activation.
该研究调查了进展性心肌梗死中的炎症反应。对15例急性心肌梗死患者进行了检查，这些患者在症状发作后4小时内接受了梗死相关冠状动脉的球囊再通术。在成功再通术前后，通过引导导管从肺动脉采集血样。再通术后，肺动脉血浆对正常供体中性粒细胞的趋化作用比再通术前增加了47%（四分位数：19%，78%；P = 0.001）。此外，在肺动脉中发现中性粒细胞功能有显著变化。与再通术前的值相比，硝基蓝四氮唑评分上升了31%（四分位数：4%，37%；P = 0.003），FMLP刺激的超氧阴离子产生增加了10%（四分位数：0%，39%；P = 0.020），趋化作用增加了46%（四分位数：0%，81%；P = 0.011），而中性粒细胞滤过率下降了28%（四分位数：15%，47%；P = 0.010）。在动脉血中未发现中性粒细胞参数有显著变化。该研究表明，在进展性心肌梗死的早期再灌注期会释放趋化因子。这些趋化因子可能作为炎症介质导致中性粒细胞活化。
