天津医药

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替罗非班对猪心肌梗死再灌注后细胞因子的影响﹡

李健1,李曦铭2,柴仁贵3,李东4,于铁链4,丛洪良2   

  1. 1. 天津医科大学；天津胸科医院
    2. 天津胸科医院
    3. 静海县医院
    4. 天津医科大学总医院
  • 收稿日期:2010-07-26 修回日期:2010-09-17 出版日期:2010-12-15 发布日期:2010-12-15
  • 通讯作者: 李健

Effects of Tirofiban on Inflammation Factors in Pigs with Myocardial Infarction Reperfusion

  • Received:2010-07-26 Revised:2010-09-17 Published:2010-12-15 Online:2010-12-15
  • Contact: Jian Li

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摘要：  目的:研究GPⅡb/Ⅲa受体拮抗剂替罗非班对猪急性心肌梗死(AMI)再灌注后细胞因子的影响。方法:将19只猪随机分为对照组(n=10)和替罗非班组(n=9)。通过介入球囊封闭冠状动脉的方法制作AMI再灌注模型。再灌注后1、24、48及72h进行DE-MSCT检查,分别于AMI前30min、AMI后30min、再灌注后10min、2h、24h、48h及72h取静脉血,应用酶联免疫吸附(ELISA)法测定血清白细胞介素(IL)-6、IL-10、缺氧诱导因子(HIF)-1α浓度。结果:(1)替罗非班组梗死心肌体积和无复流体积在再灌注后明显小于对照组(P<0.05)。(2)替罗非班组和对照组中,AMI后30min、再灌注后10min～72h各时间点的血清IL-6和IL-10水平较AMI前升高;再灌注后,替罗非班组血清IL-6水平均显著低于对照组(P<0.05),而血清IL-10水平高于对照组(P<0.05)。(3)再灌注后,血清HIF-1α较AMI前明显升高,再灌注后24、48及72h替罗非班组显著低于对照组(P<0.05)。结论:AMI再灌注后缺血心肌发生炎症反应;替罗非班能够减轻梗死再灌注后的炎症反应,进而减少心肌进一步损伤。 

关键词: 急性心肌梗死, 梗死再灌注, 无复流, 炎症因子, GPⅡb/Ⅲa受体拮抗剂/替罗非班

Abstract: Objective：To investigate the effect of tirofiban on inflammation f actors in pigs with myocardial infarction reperfusion . Methods：19 Chinese mini pigs were randomized into control group （n=10）and tirofiban-treating group（n=9）. Acute myocardial infarction was induced by method of PTCA. All the successful models accepted DE-MSCT examinations at 1 hour, 24 hours, 48 hours, and 72 hours after reperfusion. All pigs was taken blood at seven different points: 30min before AMI, 30min after AMI, 10min, 2h, 24h, 48h, 72h after reperfusion. The serum levels of IL-6, IL-10, HIF-1αwere measured by enzyme linked immunosorbent assay(ELISA). Result ：（1）The infarct myocardium volume percent was significantly reduced in tirofiban-treating group compared with control group at 24h, 48 and 72h after reperfusion; while the no-reflow volume percent was significantly reduced in tirofiban-treating group compared with control group from 1h to 72h after reperfusion. （2）In tirofiban-treating group, the levels of serum IL-6 were significantly lower than those in control group(p<0.05)，while the levels of serum IL-10 were higher than those in control group(p<0.05).（3） There were no statistical differences between the two groups(p>0.05).Conclusion：Inflammation reaction occurs in ischemic myocardium after AMI and reperfusion ; tirofiban is effective in anti-inflammation, reducing the progress of myocardial necrosis.

Key words: acute myocardial infarction, infarction reperfusion, no-reflow, inflammation factors, R5 glycoproteinⅡb/Ⅲa inhibitor/tirofiban