[Relation between inflammation related cytokines and myocardial microcirculatory reperfusion state]

To observe the dynamic fluctuation of inflammatory cytokines (IL-1beta, TNFalpha) and anti-inflammatory cytokine (IL-10) in acute myocardial infarct (AMI) patients before and after recanalization of infarct related artery (IRA) and analyze the relationship between fluctuation of cytokines and reperfusion state of myocardial tissue.

(1) In 22 AMI patients and 8 healthy subjects, plasma IL-1beta, TNFalpha and IL-10 were measured with ELISA before emergency percutaneous coronary interposition (PCI), 12 h and 24 h post-intervention. (2) The 22 AMI patients were further divided into 2 groups according to ST-segment change in ECG at 2h after reperfusion: group A, good reperfusion of myocardium, ST decrease >or= 70% (n = 12) and group B, poor reperfusion of myocardium, ST decrease < 70% (n = 10). The change of plasma levels of IL-1beta, TNFalpha and IL-10 of the two groups was compared.

(1) Plasma TNFalpha and IL-10 in group A and B were not significantly higher those that the healthy controls (P > 0.05) before emergency PCI, but IL-1beta was significantly higher (P < 0.05). Plasma IL-1beta and TNFalpha in group A and B and IL-10 in group B at 12 h and 24 h post-intervention were significantly higher than those before PCI (P < 0.01, P < 0.05, P < 0.05), while IL-10 in group A was not (P > 0.05). (2) Plasma IL-1beta, TNFalpha and IL-10 in group B were not higher than those in group A before PCI, but they were significantly higher at 12 h post-PCI (P < 0.01, P < 0.05, P < 0.05) and IL-1beta and IL-10 were still higher at 24 h post-PCI (P < 0.05). The increment of IL-10 was significantly less than that of IL-1beta and TNFalpha in group A and B (P < 0.01, P < 0.05).

Cytokines may be involved in myocardial ischemia-reperfusion injury and increase of inflammatory cytokines may be a marker of poor myocardial microcirculatory reperfusion.