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目的:探讨急性心肌梗死(AMI)患者血清钾及C-反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素4(IL-4)等炎症因子的变化。方法:选取自2012年5月至2015年7月期间于我院行冠脉造影患者198例为前瞻性研究对象,其中AMI患者71例、稳定性心绞痛(SA)患者62例及正常冠脉患者65例,分别记为AMI组、SA组及正常组。采用ELISA法检测3组患者血清CRP、TNF-α、IL-4等炎症因子水平,并行患者外周血白细胞计数及血钾浓度检测。根据血钾结果将AMI组患者分为低血钾(血钾浓度≤3.5 mmol·L-1)组和非低血钾(血钾浓度>3.5 mmol·L-1)组,对比两组患者发病至入院时间、血清胰岛素水平及外周血白细胞计数等基线资料。结果:AMI组患者的血钾水平明显低于SA组及正常组患者(P<0.05);AMI组患者血清CRP、TNF-α、IL-4等炎症因子水平明显高于SA组及正常组患者(P<0.05);Pearson相关分析提示,AMI患者血钾水平与外周血白细胞总数呈负相关(r=-0.15,P=0.041),与发病至入院时间呈正相关(r=0.23,P=0.000)。结论:AMI患者早期可出现低血钾及血清CRP、TNF-α、IL-4等炎症因子水平升高,可作为AMI的辅助诊断依据。
Objective: To investigate the changes of serum potassium and C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) in acute myocardial infarction (AMI) Methods: A total of 198 coronary angiography patients from our hospital from May 2012 to July 2015 were prospectively studied. Among them, 71 patients were AMI, 62 patients were with stable angina (SA) and 62 patients were normal coronary artery 65 patients were recorded as AMI group, SA group and normal group. Serum levels of CRP, TNF-α, IL-4 and other inflammatory cytokines were measured by ELISA. Peripheral blood leukocyte count and serum potassium levels were measured. Patients in the AMI group were divided into hypokalemia group (serum potassium concentration≤3.5 mmol·L-1) and non-hypokalemia group (serum potassium concentration> 3.5 mmol·L-1) To admission time, serum insulin levels and peripheral blood leukocyte count and other baseline data. Results: The levels of serum potassium in patients with AMI were significantly lower than those in patients with SA and normal (P <0.05). The levels of serum inflammatory cytokines such as CRP, TNF-α and IL-4 in patients with AMI were significantly higher than those in patients with SA and normal (P <0.05). Pearson correlation analysis showed that the serum potassium levels in AMI patients were negatively correlated with the total number of peripheral white blood cells (r = -0.15, P = 0.041), and positively correlated with the onset of hospitalization (r = 0.23, ). CONCLUSIONS: Early onset of hypokalemia and serum levels of CRP, TNF-α, IL-4 and other inflammatory factors may be elevated in patients with AMI, which can be used as the basis for the diagnosis of AMI.