关键词: 急性ST段抬高心肌梗死, 白细胞介素6, 可溶性白细胞分化抗原40配体, 基质金属蛋白酶－9, 基质金属蛋白酶组织抑制因子－1, 二级预防

Abstract:

Objective To investigate the changes of the levels of serum inflammatory factors and secondary prevention in patients with acute ST segment elevation myocardial infarction (STEMI) during the 3-years follow-up. Methods A vertical sectional survey was performed on 84 patients with first STEMI who were admitted to our institute within 6 h of symptoms onset. Clinical data were collected, and serum levels of interleukin-6 (IL-6), soluble CD40 ligand (sCD40L), metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were measured by sandwich enzyme-linked immunosorbent assay (ELISA) at baseline and 3 years of follow-up.Results STEMI patients at 3-years follow up had lower levels of serum IL-6, sCD40L and MMP-9, and a higher level of TIMP-1 compared with admission phrase. During the 3-years follow-up period, the proportion of STEMI patients who took angiotensin-converting enzyme inhibitors, or angiotensin Ⅱ receptor blocker and statins were 54.8%, 73.8% and 57.1% respectively, which were decreased significantly compared with those measured during hospitalization, and the rate of achieving goal of blood pressure, 1ow-density lipoprotein cholesterol and body mass index were 39.9%, 27.4% and 45.2%, respectively. Conclusion The present study indicates that elevated circulating level of interleukin-6, sCD40L, MMP-9 and imbalance between MMP-9 and TIMP-1 may be responsible at least in part for atherosclerotic plaque development and rupture. We should carry out intensive follow-up management including antihypertensive and lipid lowing intervention to improve the secondary prevention of STEMI patients after discharge.

Key words: acute ST segment elevation myocardial infarction, interleukin-6, soluble CD40 ligand, metalloproteinase-9, tissue inhibitor of metalloproteinase-1, secondary prevention