摘要
目的探讨急性心肌梗死(AMI)患者血浆IL-22水平与冠状动脉病变程度和5年预后的相关性。方法连续选择2014年10月至2016年12月在战略支援部队特色医学中心行急诊经皮冠状动脉介入治疗的AMI患者98例,分为ST段抬高型心肌梗死(STEMI)组58例和非ST段抬高型心肌梗死(NSTEMI)组40例;选择同期在战略支援部队特色医学中心心血管内科就诊且冠状动脉造影无异常者40例为对照组。采用Luminex液相芯片技术检测血浆细胞因子IL-22、IL-1β、IL-6、TNF-α水平。比较3组患者的基线资料及细胞因子水平,分析AMI患者IL-22与其他细胞因子的相关性。采用Pearson相关性分析及多元线性回归分析探究AMI患者的心脏外科与介入治疗狭窄冠状动脉研究(SYNTAX)积分与血浆IL-22等变量的关系,采用ROC曲线分析IL-22等指标对中高SYNTAX积分的预测能力,采用二分类logistic回归分析研究AMI患者出院后5年内主要不良心脑血管事件(MACCE)发生的危险因素。结果STEMI、NSTEMI组和对照组患者年龄、性别、吸烟史等基线资料差异均无统计学意义(P均>0.05);STEMI、NSTEMI组有冠心病家族史患者的比例及空腹血糖、超敏C反应蛋白、脑钠肽水平均高于对照组(P均<0.05),高密度脂蛋白胆固醇水平及左室射血分数(LVEF)均低于对照组(P均<0.05)。STEMI、NSTEMI组患者血浆IL-22、IL-1β、IL-6和TNF-α水平均高于对照组(P均<0.05)。AMI患者血浆IL-22水平与IL-1β(r=0.793,P=0.001)、IL-6(r=0.880,P<0.001)、TNF-α(r=0.840,P<0.001)水平呈正相关;SYNTAX积分与IL-22(r=0.478,P=0.001)、IL-6(r=0.242,P=0.017)、年龄(r=0.217,P=0.032)和心肌肌钙蛋白I(r=0.261,P=0.010)呈正相关,与LVEF(r=-0.224,P=0.034)呈负相关。多元线性回归分析显示,IL-22(β=0.269,P=0.023)、年龄(β=0.236,P=0.016)、LVEF(β=-0.235,P=0.023)是SYNTAX积分的影响因素。ROC曲线分析显示,IL-22对中高SYNTAX积分的预测能力(AUC=0.760,95%CI 0.656~0.863,P=0.001)高于年�
Objective To investigate the correlation between plasma interleukin(IL)-22 level and the severity of coronary artery disease and 5-year prognosis in patients with acute myocardial infarction(AMI).Methods A total of 98 AMI patients who underwent emergency percutaneous coronary intervention in Special Medical Center of Strategic Support Force from Oct.2014 to Dec.2016 were selected,including 58 cases of ST segment elevation myocardial infarction(STEMI)and 40 cases of non-ST segment elevation myocardial infarction(NSTEMI).Forty patients with normal coronary angiography during the same period were selected for control group.The plasma levels of inflammatory cytokines IL-22,IL-1β,IL-6 and tumor necrosis factorα(TNF-α)were measured by Luminex liquid chip technique.The baseline data and plasma levels of inflammatory cytokines were compared among the 3 groups to analyze the relationship between IL-22 level and other inflammatory cytokines in AMI patients.Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between plasma IL-22 level and SYNergy between percutaneous coronary intervention with TAXUS^(TM) and cardiac surgery(SYNTAX)score.Receiver operating characteristic(ROC)curve was used to analyze the prediction ability of some indexes(such as IL-22)for medium-high SYNTAX scores.Binary logistic regression analysis was used to analyze the risk factors of major adverse cardiovascular and cerebrovascular event(MACCE)in patients with AMI within 5 years after discharge.Results There were no significant differences in baseline data such as age,gender or smoking history between the AMI group and control group(all P>0.05).The proportions of patients with family history of coronary heart disease,fasting blood glucose,hypersensitive C reactive protein and brain natriuretic peptide in the STEMI and NSTEMI groups were higher than those in the control group(all P<0.05),while the levels of high density lipoprotein�cholesterol and left ventricular ejection fraction(LVEF)were lo
作者
李天伦
张中
赵蓓
殷召
毛帅
冯雪瑶
张士丹
周珮
李奇恒
张洁
崔佳
崔会平
刘莉
王守力
LI Tian-lun;ZHANG Zhong;ZHAO Bei;YIN Zhao;MAO Shuai;FENG Xue-yao;ZHANG Shi-dan;ZHOU Pei;LI Qi-heng;ZHANG Jie;CUI Jia;CUI Hui-ping;LIU Li;WANG Shou-li(The Fifth Clinical Medical College,No.306 Clinical College of PLA,Anhui Medical University,Beijing 100101,China;Department of Cardiovasology,PLA Strategic Support Force Characteristic Medical Center,Beijing 100101,China)
出处
《海军军医大学学报》
CAS
CSCD
北大核心
2022年第4期398-405,共8页
Academic Journal of Naval Medical University
