内源性促红细胞生成素在急性心肌梗死介入前后的动态变化及心肌保护作用和抗炎作用

摘要

目的:探讨内源性促红细胞生成素(EPO)在急性心肌梗死(AMI)介入前后的动态变化及心肌保护作用和抗炎作用.方法:选择78例6 h内行急诊经皮冠脉介入的AMI患者作为病例组.检测入院即刻和术后6、24、48、72 h的血清EPO、IL-6、hs-CRP,并检测入院即刻和术后6、12、24、48、72 h的三联水平.另外选择36例健康体检者作为正常对照组(NC组),仅检测体检当天的EPO、IL-6、hs-CRP和三联,进行统计学分析.结果:AMI组术前EPO、IL-6、hs-CRP、三联均高于NC组(P<0.05),Mb、eTnI、CKMB、IL-6、hs-CRP分别于术后6、12、12、24、48 h达到峰值,EPO于术后24 h降到最低;术前和术后24 h AMI组EPO与IL-6、hs-CRP、三联均呈负相关(P<0.05).结论:内源性EPO在AMI介入前后存在应激性升高,具有减小心肌梗死面积的心肌保护作用和抗炎作用.%Objective To research the dynamic of endogenous erythropoietin (EPO) after intervention in acute myocardial infarction (AMI) and the cardiovascular protective and antiinflamative effects ct it. Methods Seventy-eight patients with AMI who received percutaneous coronary intervention (PCI) within 6 hours after symptom onset were included in patient group. Levels of EPO, interleukin-6 (IL,-6), and high sensitivity C-reactive protein (hs-CRP) were measured at admission, hour 6, 24, 48, and 72 after PCI. And trigeminy was measured at admission, hour 6, 12, 24, 48, and 72 after PCL Thirty-six normal controls (NC group) received measurement of the levels of EPO, IL-6, hs-CBP, and trigeminy. Results The levels of EPO, IL,-6, hs-CRP, and trigeminy were higher in patient group than those in NC group. Mb, cTnI, CKMB, IL,-6, and hs-CRP reached their maximum at hour 6, 12, 12, 24, and 48 after PCI, while EPO was decreased to the minimum at hour 24. EPO was negatively associated with IL-6, hs-CRP, and trigeminy at admission and hour 24 after PCI (P ＜ 0.05). Conclusions Endogenous EPO is increased irritably in AMI after intervention, and there may be myocardial protective effect of reducing myocardial infarction size and antiinflammative effect of EPO.