急性心肌梗死患者经皮冠状动脉介入治疗术后慢血流发生与梗死相关动脉病变局部白细胞介素-6水平的关系

被引:15
作者
董梅 [1 ]
任法新 [1 ]
牟楠 [2 ]
张传焕 [1 ]
李建平 [1 ]
陶志刚 [1 ]
杨军 [1 ]
机构
[1] 烟台毓璜顶医院心内科
[2] 烟台毓璜顶医院妇科
关键词
白细胞介素-6; 慢血流; 炎症反应; 急性心肌梗塞;
D O I
暂无
中图分类号
R542.22 [];
学科分类号
1002 ; 100201 ;
摘要
目的:探讨ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后慢血流发生风险与梗死相关动脉管病变局部白细胞介素-6(IL-6)水平的关系。方法:共纳入STEMI行急诊PCI的患者56例,其中男性34例,女性22例,平均年龄(63.5±10.3)岁。PCI术前应用6F Diver CE抽吸导管在导丝支持下,于冠状动脉病变的远端局部取样,采用酶联免疫吸附法测定IL-6水平。结果:共计21例(37.5%)患者发生慢血流。多因素Logistic回归分析表明糖尿病(OR=0.124,95%CI:0.019-0.804,P=0.029)、血栓负荷评分(OR=0.080,95%CI:0.007-0.909,P=0.042)、局部IL-6(OR=0.623,95%CI:0.441-0.881,P=0.007)是慢血流发生的独立危险因素。ROC曲线表明局部IL-6(ROC面积0.824,OR=1.704,95%CI:1.274-2.281,P=0.001;理想阈值:≥11.3pg/ml)对慢血流的发生具有重要预测价值(敏感性为73%,特异性为71%)。结论 :梗死相关动脉病变局部IL-6水平升高与STEMI患者行急诊PCI术后慢血流的发生密切相关。
引用
收藏
页码:185 / 188
页数:4
相关论文
共 13 条
[1]   组织因子和组织因子途径抑制物与心肌无复流 [J].
黎娜 ;
李宪伦 .
中国循环杂志, 2011, 26 (04) :317-319
[2]   急性心肌梗死经皮冠状动脉介入治疗术后无复流的防治进展 [J].
陈韵岱 ;
王长华 .
中国循环杂志, 2010, 25 (03) :165-166
[3]  
Impact of inflammatory state and metabolic control on responsiveness to dual antiplatelet therapy in type 2 diabetics after PCI: prognostic relevance of residual platelet aggregability in diabetics undergoing coronary interventions[J] . Tobias Geisler,Karin Mueller,Simon Aichele,Boris Bigalke,Konstantinos Stellos,Patrick Htun,Elena Ninci,Susanne Fateh-Moghadam,Andreas E. May,Meinrad Gawaz.Clinical Research in Cardiology . 2010 (11)
[4]  
Coronary no‐reflow phenomenon: From the experimental laboratory to the cardiac catheterization laboratory[J] . Shereif H.Rezkalla,Robert A.Kloner.Cathet. Cardiovasc. Intervent. . 2008 (7)
[5]  
Increased plasma C-reactive protein and interleukin-6 concentrations in patients with slow coronary flow[J] . Jian-Jun Li,Xue-Wen Qin,Zi-Cheng Li,He-Song Zeng,Zhan Gao,Bo Xu,Chao-Yang Zhang,Jie Li.Clinica Chimica Acta . 2007 (1)
[6]  
Increased plasma soluble adhesion molecules;ICAM-1, VCAM-1, and E-selectin levels in patients with slow coronary flow[J] . Hasan Turhan,Gul Sevim Saydam,Ali Riza Erbay,Selime Ayaz,Ayse Saatci Yasar,Yuksel Aksoy,Nurcan Basar,Ertan Yetkin.International Journal of Cardiology . 2005 (2)
[7]  
Angiographic perfusion score: An angiographic variable that integrates both epicardial and tissue level perfusion before and after facilitated percutaneous coronary intervention in acute myocardial infarction[J] . C.Michael Gibson,Sabina A. Murphy,David A. Morrow,Julian M. Aroesty,Raymond J. Gibbons,Steven G. Gourlay,Hal V. Barron,Robert P. Giugliano,Elliott M. Antman,Eugene Braunwald.American Heart Journal . 2004 (2)
[8]   No-reflow is an independent predictor of death and myocardial infarction after percutaneous coronary intervention [J].
Resnic, FS ;
Wainstein, M ;
Lee, MKY ;
Behrendt, D ;
Wainstein, RV ;
Ohno-Machado, L ;
Kirshenbaum, JM ;
Rogers, CDK ;
Popma, JJ ;
Piana, R .
AMERICAN HEART JOURNAL, 2003, 145 (01) :42-46
[9]   Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction [J].
Morishima, I ;
Sone, T ;
Okumura, K ;
Tsuboi, H ;
Kondo, J ;
Mukawa, H ;
Matsui, H ;
Toki, Y ;
Ito, T ;
Hayakawa, T .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 36 (04) :1202-1209
[10]   Relationship between TIMI frame count and clinical outcomes after thrombolytic administration [J].
Gibson, CM ;
Murphy, SA ;
Rizzo, MJ ;
Ryan, KA ;
Marble, SJ ;
McCabe, CH ;
Cannon, CP ;
Van de Werf, F ;
Braunwald, E .
CIRCULATION, 1999, 99 (15) :1945-1950