Neumann F J, Richardt G, Schneider M, Ott I, Haupt H M, Tillmanns H, Schömig A, Rauch B
I Medizinische Klinik, Technische Universität, München, Germany.
Br Heart J. 1993 Jul;70(1):27-34. doi: 10.1136/hrt.70.1.27.
To investigate the release of chemoattractants after myocardial ischaemia during balloon angioplasty.
Sampling of femoral arterial and coronary sinus blood before and immediately after the first balloon inflation during angioplasty. In a study group of 16 patients the balloon was kept expanded for two minutes, whereas in a control group of eight patients the first balloon inflation was brief (< 10 s).
Chemotaxis of neutrophils from healthy donors towards patient plasma (Boyden chamber), superoxide anion production by normal neutrophils after incubation with patient plasma (cytochrome C reduction).
In the study group, coronary sinus plasma after balloon deflation was more chemoattractive to normal neutrophils (median relative increase 24% (quartiles: 4%, 45%), p = 0.008) and induced a higher superoxide anion production in normal neutrophils (44% (10%, 97%), p = 0.013) than arterial plasma. Concomitantly, the degree of activation of patient neutrophils was increased in coronary sinus blood compared with arterial blood, as shown by an increased proportion of neutrophils reducing nitro-blue tetrazolium (21% (9%, 38%), p = 0.006) and a decreased neutrophil filter-ability (-16%(-3%, -40%), p = 0.003) in coronary sinus blood. In the study group before balloon inflation and in the control group before and after balloon inflation differences between arterial and coronary sinus blood were not significant. Signs of ischaemia (lactate release, ST segment changes) were only detected in the study group.
After transient myocardial ischaemia during balloon angioplasty there is a local release of chemoattractants, associated with neutrophil activation.
研究球囊血管成形术期间心肌缺血后趋化因子的释放情况。
在血管成形术首次球囊扩张前及扩张后即刻采集股动脉和冠状窦血液样本。在16例患者的研究组中，球囊保持扩张2分钟，而在8例患者的对照组中，首次球囊扩张时间短暂（<10秒）。
健康供体中性粒细胞对患者血浆的趋化作用（Boyden小室法），正常中性粒细胞与患者血浆孵育后超氧阴离子的产生（细胞色素C还原法）。
在研究组中，球囊放气后冠状窦血浆对正常中性粒细胞的趋化作用更强（中位数相对增加24%（四分位数间距：4%，45%），p = 0.008），且诱导正常中性粒细胞产生更高的超氧阴离子（44%（10%，97%），p = 0.013），高于动脉血浆。同时，与动脉血相比，冠状窦血中患者中性粒细胞的活化程度增加，表现为还原硝基蓝四氮唑的中性粒细胞比例增加（21%（9%，38%），p = 0.006），以及冠状窦血中中性粒细胞过滤能力降低（-16%（-3%，-40%），p = 0.003）。在研究组球囊扩张前以及对照组球囊扩张前后，动脉血与冠状窦血之间的差异不显著。仅在研究组中检测到缺血迹象（乳酸释放、ST段改变）。
球囊血管成形术期间短暂心肌缺血后，存在趋化因子的局部释放，并伴有中性粒细胞活化。
