Heart:IL-6抑制剂不影响心肌梗死患者冠脉血流储备

2017-09-26 王淳 环球医学

2017年10月,发表在《Heart》上的一项由挪威科学家进行的双中心、双盲、随机、安慰剂对照试验,考察了白细胞介素-6(IL-6)抑制剂对心肌梗死患者冠状动脉微血管和血管内皮功能的影响。



2017年10月,发表在《Heart》上的一项由挪威科学家进行的双中心、双盲、随机、安慰剂对照试验,考察了白细胞介素-6(IL-6)抑制剂对心肌梗死患者冠状动脉微血管血管内皮功能的影响。

目的:IL-6是炎症的驱动因子,与急性冠脉综合征患者血管内皮细胞激活相关。研究人员评估了IL-6受体拮抗剂托珠单抗对非ST段抬高心肌梗死(NSTEMI)患者冠脉血流储备(CFR)和内皮细胞激活标志物测量的冠脉微血管功能和血管内皮功能障碍的影响。

方法:该子研究为评估单剂量托珠单抗治疗NSTEMI作用的双中心、双盲、随机、安慰剂对照试验的一部分。内皮细胞激活标志物(血管细胞粘附分子(VCAM)-1、细胞间粘附分子-1、血管假性血友病因子)在117例患者中进行了评估。其中的42人中,20人分配到安慰剂组,22人分配到托珠单抗组,我们对两组患者都检测了CFR。在1~3天的7个连续时间点收集了血液样本。通过经胸超声心动图检测了住院期间和6个月后的CFR。

结果:托珠单抗不影响住院期间的CFR(托珠单抗:3.4±0.8 vs安慰剂:3.3±1.2;P=0.80)。6个月时,两组的CFR都显着改善。塔西单抗组的患者具有显着性高的VCAM -1曲线下面积(中位622 vs 609ng/mL/时,P=0.003)。安慰剂组中,VCAM-1和CFR具有负相关性(住院:r=-0.74,P<0.01;6个月:r=-0.59,P<0.01),而托珠单抗组并非如此(住院:r=0.20,P=0.37;6个月:r=-0.28,P=0.20)。

结论:托珠单抗不影响住院或6个月后的CFR。托珠单抗增加住院期间的VCAM-1水平,但是与CFR的降低不相关。

原始出处:

Holte E, Kleveland O, Ueland T, et al. Effect of interleukin-6 inhibition on coronary microvascular and endothelial function in myocardial infarction. Heart. 2017 Oct;103(19):1521-1527. doi: 10.1136/heartjnl-2016-310875. Epub 2017 Apr 21.

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    2018-08-30 jklm09
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    2017-09-28 kzlchina
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    2017-09-28 zhaojie88
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    2017-09-28 slcumt

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