摘要
探讨急性心肌梗塞（ＡＭＩ）心肌缺血再灌注过程中血浆白细胞介素６（ＩＬ－６）的动态变化及其意义和其单克隆抗体的保护作用。方法（１）用ＥＬＩＳＡ方法和ＦＡＣＳＯＲＴ流式细胞仪测定２８例经链激酶（ＳＫ）或重组组织型纤溶酶原激活剂（ｔ－ＰＡ）溶栓治疗的ＡＭＩ患者入院即刻，再灌注１、４．５、１０．２０小时血浆ＩＬ－６水平和中性粒细胞表面粘附分子（ＣＤ１１ｂ）蛋白表达。（２）在兔的缺血再灌注模型上检测ＩＬ－６和ＣＤ１１ｂ，以及缺血心肌组织白细胞聚积和髓过氧化酶（ＭＰＯ）活性。结果（１）２８例ＡＭＩ患者中，１３例溶栓治疗后血管再通（Ａ组），１５例未通（Ｂ组）。两组溶栓治疗前ＩＬ－６和ＣＤ１１ｂ表达差异无显著性，但明显高于正常对照组（Ｐ＜０．０１），Ａ组在血管再通后１小时、４．５小时显著高于Ｂ组。（２）在兔缺血再灌注模型上，血浆ＩＬ－６和ＣＤ１１ｂ的表达和ＡＭＩ患者相似。在缺血心肌组织中，中性粒细胞和ＭＰＯ的活性明显升高。ＩＬ－６释放与ＣＤ１１ｂ表达及ＭＰＯ活性相关（ｒ＝０．９２４，０．６２２，Ｐ＜０．０１）。缺血１．５小时后再灌注４小时比单纯心肌缺血１．５小时梗塞面积扩大［（４３．８±３．９）％ｖｓ（３８．７±３．５）％?
Objective In order to study the change and role of plasma interleukin-6 (IL-6) and the effectof its monoclonal antibody (McAb-IL6) during myocedial infarction reperfusion in acute myocardial infarction(AMI). Methods (1) In 28 patients with AMI who received SK or rt-PA thrombolysis plasma IL-6 by ELISAand CD11b expression of neutrophil by flowcytometry were measured at accession and 1,4.5, 10, 20 hours aftertherapy. (2) In the rabbit model with ischemia reperfusion, similar measurements were performed as well as theaccumulation of neutrophils and myeloperoxidase (MPO) activity in ischemic cardiac tissue. Results (1) Among28 patients, 13 of them developed reperfusion (Group A) and 15 did not (Group B). Plasma IL-6 level andCD1 1b expression at admission were not different between Group A and Group B, but markedly higher than those ofthe normal controls (P<0.01), and lasted to 24 hours after AMI. Plasma IL-6 level and CD11b expression weresignificantly higher in Group A than in Group B at 1 and 4.5 hours after reperfusion (P<0.01, P<0.01). (2)In the rabbit model, the changes of plasma IL-6 level and CD11b expression were similar to those of AMI patients.In addition, accumulation of neutrophils and MPO activity significantly increased in ischemic cardiac tissue. IL-6release was correlated with CD11b expression and MPO activity (r=0.924 and 0.622, respectively, P<0.01).Reperfusion (4 hrs) following ischemia (1.5 hrs) significantly increased size of myocardial infaret compared withischemia (1.5hrs) alone [(43.8±3.9) % vs (38.7±3.5)%, P<0.05], whereas it markedly reducedinfarct size compared with ischemia (5.5 hrs) [(43.8±3.9)% vs (52.9±4.8) %, P<0.05]. McAb-IL6treated rabbits showed less CD11b expression, MPO activity and infarction size [ (27.5±3) % vs (43.8±3.9)%, P<0.01]. Conclusion IL-6 plays a critical role in myocardial ischemia postreperfusion inflammatoryinjury. Monitoring the changes of plasma IL-6 and CD11b would help to recognize myocardial ischemia reperfusioninjury. McAb IL-6 might be useful clinically at reducing myocardial ischemia postreperfusion inflammatory injury.
出处
《中华心血管病杂志》
CSCD
北大核心
1999年第1期29-32,共4页
Chinese Journal of Cardiology
基金
国家教委博士点基金!No:9501030
关键词
白细胞介素6
单克隆抗体
心肌梗塞
再灌注损伤
interleukin-6 monoclonal antibody myocardial infarction reperfusion injury
