Objective: 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.
Methods: (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.
Results: (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).
Conclusions: Cytokines may be involved in myocardial ischemia-reperfusion injury and increase of inflammatory cytokines may be a marker of poor myocardial microcirculatory reperfusion.